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AAAAI/ACAAI Joint Task Force on Allergy/Immunology Practice Parameters and AGA Release Guideline on the Management of Eosinophilic Esophagitis (EoE)

AAAAI News Release

April 28, 2020

April Presnell


Guideline provides evidence-based recommendations for allergists and gastroenterologists focusing on the clinical management of EoE for pediatric and adult patients.

Milwaukee, Wisconsin — Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus triggered by allergens that causes difficulty with swallowing in adults, which grows more frequent and intense over time, affecting patients’ quality of life. Children experience varied symptoms that include feeding difficulty, pain, vomiting, as well as dysphagia. EoE affects an estimated one in 2,000 people.

A new guideline from the Joint Task Force for Allergy/Immunology Practice Parameters—comprised of the American Academy of Allergy, Asthma & Immunology (AAAAI) and the American College of Allergy, Asthma & Immunology (ACAAI)—and the American Gastroenterological Association (AGA) provides recommendations for the management of EoE in pediatric and adult patients.

Key guideline highlights:
•    Topical steroids are recommended as a first-line treatment for EoE.
•    The guideline also recommends proton pump inhibition (PPI) therapy, diet therapy and esophageal dilation as treatment options.
•    The use of novel, targeted biologic therapies for EoE are being actively evaluated and more research is needed before these can be recommended.

“Allergists and gastroenterologists are seeing many more patients with EoE, which is considered to be a chronic condition that can be medically managed but not outgrown. This new guideline provides important evidence-based recommendations for managing EoE that will help us continue to move towards optimal care for all EoE patients,” said AAAAI President Mary Beth Fasano, MD, MSPH, FAAAAI.

“Over the past two decades, EoE has emerged as a dominant cause of swallowing difficulties worldwide,” said Ikuo Hirano, MD, AGAF, a gastroenterologist from Northwestern University Feinberg School of Medicine, Chicago, Illinois, and lead guideline author. “The recommendations we’ve outlined will guide allergists and gastroenterologists in effectively managing their patients’ EoE and improving their quality of life. As the field moves forward, a deeper understanding of the natural history of EoE in both children and adults is needed to inform clinical decisions regarding the optimal use of disease monitoring and long-term, maintenance therapy.”
This guideline was developed through a collaboration between the Joint Task Force for Allergy/Immunology Practice Parameters and the AGA. It is jointly published in Gastroenterology, the official journal of the AGA Institute, and Annals of Allergy, Asthma and Immunology, the scientific journal of the ACAAI.

Review the guideline for the complete recommendations.

What Is EoE?
EoE is a chronic inflammatory disease of the esophagus triggered by food and environmental allergens. Patients with EoE experience difficulty swallowing, vomiting and pain, potentially resulting in poor eating and growth among infants and toddlers. In children and adults with EoE, solid food can get stuck in a narrowing esophagus, increasing the risk of emergency room visits for the removal of trapped food. EoE is a recently recognized disease with increasing prevalence. EoE affects an estimated one in 2,000 people. Treatment focuses on alleviating both symptoms and esophageal inflammation while helping people maintain their quality of life. Learn more about EoE at the AAAAI website.

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About the American Academy of Allergy, Asthma & Immunology
The American Academy of Allergy, Asthma & Immunology (AAAAI) represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has more than 7,100 members in the United States, Canada and 72 other countries. The AAAAI’s Find an Allergist/Immunologist service is a trusted resource to help you find a specialist close to home.

About the American College of Allergy, Asthma & Immunology (ACAAI)
The ACAAI is a professional medical organization of more than 6,000 allergists-immunologists and allied health professionals, headquartered in Arlington Heights, Ill. The College fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy and research. ACAAI allergists are board-certified physicians trained to diagnose allergies and asthma, administer immunotherapy, and provide patients with the best treatment outcomes. For more information and to find relief, visit  

About the AGA Institute
The American Gastroenterological Association is the trusted voice of the GI community. Founded in 1897, the AGA has grown to more than 16,000 members from around the globe who are involved in all aspects of the science, practice and advancement of gastroenterology. The AGA Institute administers the practice, research and educational programs of the organization. Visit

About Gastroenterology
Gastroenterology, the official journal of the AGA Institute, is the most prominent scientific journal in the specialty and is in the top 1 percent of indexed medical journals internationally. The journal publishes clinical and basic science studies of all aspects of the digestive system, including the liver and pancreas, as well as nutrition. The journal is abstracted and indexed in Biological Abstracts, Current Awareness in Biological Sciences, Chemical Abstracts, Current Contents, Excerpta Medica, Index Medicus, Nutrition Abstracts and Science Citation Index. For more information, visit

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