Eosinophilic oesophagitis (EE) is a clinico-pathological entity recognized with 
increased frequency in children and adults. It is an atopic disease involving 
ingested and inhaled allergens. A pathological eosinophilic infiltrate is 
diagnosed by finding ≥ 15 eosinophils per high-powered field on oesophageal 
mucosal biopsies. This infiltrate may result in a narrowed oesophageal lumen. It 
does not involve the stomach or duodenum. Children commonly present with 
abdominal pain, vomiting and dysphagia. Presentation in adults is with 
dysphagia, heartburn, chest pain or impaction of a food bolus in the oesophagus. 
There is often a history of allergy (asthma, hay fever, eczema). A male 
predominance (70% in adults) is unexplained. Distinctive endoscopic features are 
linear furrows, mucosal rings and white papules, and the narrowed lumen may be 
appreciated. Although EE and gastro-oesophageal reflux disease are separate 
entities, there is a significant overlap of the conditions. Treatment options 
include nonpharmacological approaches including an elimination or elemental 
diet, and/ or medications, chiefly with corticosteroids. The topical 
administration of fluticasone propionate has been demonstrated to improve 
symptoms and mobilize the pathological infiltrate of eosinophils. There has been 
a variable effect with the leukotriene receptor antagonist montelukast and 
promising early results with mepolizumab, a monoclonal antibody against 
interleukin-5. The long-term efficacy of topical corticosteroids has not been 
well studied and most patients experience recurrent symptoms when treatment is 
completed. Currently, repeated short courses of topical corticosteroids are 
utilized. Acid suppression by a proton pump inhibitor may be considered in view 
of the overlap between EE and gastro-oesophageal reflux disease.