EoE – endoscopy for diagnosis — RACP Paediatrics MCQ

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ModerateGIEoE – endoscopy for diagnosisRACP Paediatrics

A 14-year-old with suspected eosinophilic oesophagitis has dysphagia and food impaction. A PPI trial for 8 weeks has not improved symptoms. What is the most appropriate investigation?

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Correct answer: C — Upper GI endoscopy

Upper GI endoscopy with multiple oesophageal biopsies (at least 6 from proximal and distal oesophagus) is the diagnostic investigation for EoE. Current guidelines no longer require PPI non-response before diagnosing EoE. Endoscopic findings (rings, furrows, exudates) and histology (≥15 eos/HPF) confirm the diagnosis.

Reference: RCH Melbourne – 2023 – EoE CPG; ESPGHAN – 2024 – EoE Guidelines