Coping with Eosinophilic Esophagitis

What is eosinophilic esophagitis?

Eosinophilic esophagitis (EoE) is an inflammatory condition in which white blood cells (called eosinophils) build up in the esophagus, the tube connecting the mouth to the stomach. This build-up can lead to symptoms including difficulty swallowing, pain, nausea, regurgitation, and vomiting. Over time, EoE can cause the esophagus to narrow, increasing the risk of food getting stuck.

How can eosinophilic esophagitis impact a child’s emotional and behavioral health?

EoE can affect a child’s quality of life in many areas, including eating, sleeping, attending school, interacting socially, and participating in age-appropriate activities. Children and teens may experience anxiety, especially around eating, food reactions, or mealtimes away from primary caregivers. Children also may experience low mood, frustration, or behavior changes related to managing their EoE and feeling different from their peers.

What can help children cope with eosinophilic esophagitis?

Managing EoE, including taking medications and following a restricted diet, can be difficult for anyone, especially a child. If your child seems to have difficulty coping with EoE treatment, the following strategies may help:

• Encourage your child to name their feelings and use words to describe their emotions to help them build emotional awareness and obtain support. For example: “I feel nervous eating lunch at school.”
• Practice active coping strategies such as diaphragmatic (abdominal) breathing, progressive muscle relaxation, or guided imagery to reduce stress and anxiety.
• Help your child practice explaining EoE and their treatment plan in simple language to peers, teachers, or other caregivers.
• Plan ahead for outings or events by choosing or preparing safe foods ahead of time. This can help children feel prepared and give them a sense of control.
• If possible, connect with other children who have EoE through local support groups or virtual communities.

How can caregivers help their child cope with eosinophilic esophagitis?

Caregivers can be a great source of comfort and help children navigate living with EoE:

• Normalize and validate your child’s emotions. It is okay for them to feel anxious, frustrated, sad, or different sometimes. Encourage them to talk about their feelings with you, their doctor, or a trusted adult.
• Praise and reward your child’s effort to participate in caring for their EoE. For example, “Thank you for taking your medication right away!” or “You were so brave to eat that, even when you were feeling nervous.”
• Talk openly with your child and encourage them to problem-solve with you when there are difficulties or barriers to following their medical treatment plan. Stay in touch with your child’s medical providers and communicate any questions, concerns, or challenges you have so that they can help.
• Work with your child’s school to develop a health support plan (or Section 504 Plan) to address the likely need for your child to sometimes miss school due to doctors’ appointments or medical procedures and for them to have access to safe foods at school for lunch, snack times, and during classroom celebrations. 
• Consider whether a pediatric psychologist or other behavioral health provider familiar with pediatric chronic medical conditions would be helpful to include as part of your child’s healthcare team. Cognitive behavioral therapy (CBT) is an evidence-based treatment to reduce anxiety and support emotional adjustment in children with chronic medical conditions. 

Resources

Website

• American Partnership for Eosinophilic Disorders

Books

• Eating Isn’t Always Easy: Ben’s story about his Eosinophilic Esophagitis by Nancy S. Rotter, PhD, and Qian Yuan, MD, PhD
• Macaroni Isn’t The Same Without Cheese: Danny’s story about his Eosinophilic Esophagitis by Qian Yuan, MD, PhD, Nancy S. Rotter, PhD, and Phoebe Rotter

Authors: Kelsey L. Jong, PhD, and Kelly A. O’Neil Rodriguez, PhD
Editor: Amanda Deacy, MD
July 2025