Which diagnostic tests are recommended for confirming eosinophilic oesophagitis in primary care?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

The provided UK guidelines do not specify diagnostic tests recommended for confirming eosinophilic oesophagitis in primary care ,,.

The guidelines primarily focus on the assessment and diagnosis of food allergies in children and young people ,,. For suspected IgE-mediated food allergy, an allergy-focused clinical history and physical examination are crucial . Diagnostic tests that may be offered include skin prick tests and/or blood tests for specific IgE antibodies to suspected foods ,,. These tests should only be undertaken by healthcare professionals with appropriate competencies to select, perform, and interpret them ,,. Skin prick tests require facilities to manage an anaphylactic reaction . Serum-specific IgE testing is widely available, but results are not immediate ,. It is important to interpret test results in the context of the clinical history, as allergy testing cannot distinguish between sensitization and clinical allergy ,.

For suspected non-IgE-mediated food allergy, a trial elimination of the suspected allergen (typically 2–6 weeks) followed by reintroduction is suggested, with advice from a dietitian .

Oral food challenges are considered the gold standard for confirming food allergy but are not recommended for diagnosing IgE-mediated food allergy in primary care or community settings ,,.

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