Eosinophilic esophagitis (EoE) is a relatively new disease that is increasingly 
recognized as a chronic inflammatory condition with currently evolving 
diagnostic and therapeutic aspects. There is data to support the rising 
prevalence of EOE especially in western countries. EoE is an emerging cause of 
dysphagia and food bolus impaction in adults as well as abdominal pain, feeding 
disorders, and gastroesophageal reflux-like symptoms in younger patients. EoE is 
ever more recognized as a separate disease process that is more complicated than 
eosinophilic infiltration from gastroesophageal reflux disease. Food and 
environmental antigens both play significant roles in stimulating T-helper 
(Th-2) inflammatory response. Current therapeutic options include use of 
proton-pump inhibitors, immunosuppressive drugs, elimination diets, and 
esophageal dilatation. Simple elimination of food and environmental antigen 
exposure can be challenging in adults due to the difficulty in accurately 
identifying triggering antigens and adherence to restrictive diets from a wide 
range of putative food allergens. Novel therapeutic options are being presented 
as potential treatments that target chemokines and specific immunologic 
mechanisms for EoE. This review will aim to summarize the latest and evolving 
approaches to EoE diagnosis and management. In the future, biomarkers of 
inflammatory response may help diagnose, treat, and stratify individual patients 
for better treatment outcomes with this chronic disease.