Eosinophilic Oesophagitis (EoE) in Singapore

Written & reviewed by the BestDoctors.sg editorial team · Last updated 24 Aug 2026 · General information, not medical advice

Food that is completely stuck so you cannot swallow your own saliva — drooling or spitting saliva — is a food-bolus emergency: go to the hospital emergency department straight away.

What causes it

EoE is a type-2 (allergic) immune response, usually driven by food antigens and sometimes worsened by airborne allergens. The most commonly implicated foods, identified through elimination diets, are milk (dairy), wheat, egg, soy, nuts and fish or shellfish — with milk and wheat the most frequent single triggers. It is strongly linked to other allergic conditions such as eczema, asthma, allergic rhinitis and food allergy, often runs in families, and is more common in males. It is not caused by anything the patient did wrong.

Symptoms

In adults and teenagers, the typical symptoms are difficulty swallowing (especially dry or solid foods such as bread, meat or rice), a feeling of food sticking, needing to drink a lot to wash food down, eating slowly, cutting food very small or avoiding certain textures, chest or upper-tummy pain, and reflux-like symptoms that do not fully respond to acid medication. Young children may show feeding difficulty, food refusal, poor weight gain, vomiting or tummy pain. The course is chronic and relapsing: there is no cure yet, but symptoms can usually be controlled well, and untreated inflammation can progress to fixed narrowing over time.

Red flags

The key emergency is a food bolus that will not pass. If food is stuck and you cannot swallow your own saliva — you are drooling or spitting it out — go to the emergency department immediately, as this often needs urgent endoscopy to remove the food. As a rule of thumb, stuck food that has not passed after about two hours warrants a hospital visit, and inability to swallow saliva means going straight away. Never try to force food down or make yourself vomit. Severe chest pain, or chest pain with breathlessness or sweating, should be assessed urgently to exclude a heart cause, and sudden severe difficulty breathing means calling 995.

How it is diagnosed

EoE is managed by a gastroenterologist, often with an allergist, and by a paediatric gastroenterologist in children. Diagnosis requires an upper endoscopy (gastroscopy) with biopsies, even if the oesophagus looks normal — multiple biopsies are examined for eosinophils, and a threshold count supports the diagnosis. The endoscopy may show rings, furrows, white plaques or narrowing. Acid reflux is considered and often treated as part of the modern diagnostic pathway. Allergy testing may be offered but does not reliably predict which foods are the culprits in EoE, so triggers are usually found by diet rather than by test.

Treatment

Treatment is often summarised as the “three Ds” — drugs, diet and dilation — and is individualised and usually long-term. Proton-pump inhibitors are a common first-line option and reduce eosinophils and symptoms in a good proportion of patients. Swallowed topical corticosteroids (taken in a form that coats the oesophagus rather than being inhaled) reduce inflammation. Dietary elimination removes common trigger foods, then reintroduces them one at a time with repeat endoscopy to identify culprits — best done with a dietitian to avoid nutritional gaps. Oesophageal dilation gently widens any narrowing to relieve swallowing difficulty, and is usually combined with drug or diet therapy because it does not treat the underlying inflammation. A targeted biologic therapy is approved for EoE in some countries; availability and subsidy vary, so discuss it with your specialist. Because EoE can relapse if treatment stops, ongoing monitoring is part of care.

Eating and living with EoE

Day-to-day habits help while treatment does its work. Many people find it easier to eat slowly, take smaller bites, chew thoroughly and sip fluids with meals, and to be cautious with dry, dense foods such as bread, tough meat and rice that are most likely to catch. If you are following an elimination diet, working with a dietitian keeps it nutritionally sound and makes the reintroduction steps clearer, so you avoid cutting out more than you need to. It also helps to keep track of any episodes of food sticking and to share these with your specialist, since a rising frequency can signal that inflammation or narrowing needs review. Learning the food-bolus emergency plan — and making sure those you eat with know it too — means a stuck-food episode is handled calmly and quickly.

When to see a doctor

See a doctor for persistent trouble swallowing, food sticking, or reflux symptoms not responding to usual acid treatment, and arrange assessment after any episode of food getting stuck even if it passes. In children, feeding refusal, recurrent vomiting or poor weight gain warrant review. Go to the emergency department for an acute stuck food bolus with inability to swallow saliva.

Related allergy & immunology topics

• Allergy testing
• Angioedema
• Allergen immunotherapy (desensitisation)
• Insect sting & venom allergy
• Allergic conjunctivitis (eye allergy)
• Oral allergy syndrome
• House dust mite allergy
• Food intolerance
• Latex allergy
• Allergic rhinitis
• Drug allergy
• Allergists in Singapore
• Achalasia

Sources

• ACAAI — Eosinophilic Esophagitis: acaai.org
• AAAAI — Eosinophilic Esophagitis: aaaai.org
• American Partnership for Eosinophilic Disorders (APFED): apfed.org
• Guts UK — Eosinophilic Diseases: gutscharity.org.uk
• Mayo Clinic — Eosinophilic esophagitis: mayoclinic.org