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Eosinophilic oesophagitis (EoE) clinic - a joint allergy and gastro pathway for EoE.

For children and adults with eosinophilic oesophagitis needing diagnosis, treatment and follow-up. A joint paediatric or adult allergist and gastroenterologist pathway, with endoscopy, PPI, diet or dupilumab.

A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private EoE clinic costs in the UK.

In short

EoE pathway: joint consult + endoscopy + first-line treatment for £2,500–£5,500.

ItemIndicative range
Joint allergy + gastro consultation£350–£600
Diagnostic endoscopy + biopsies (paediatric)£2,200–£3,800
Adult diagnostic OGD + biopsies£1,200–£2,200
Topical swallowed steroid (orodispersible)£150–£300 per month
PPI trial + review£150–£300 total
Dietitian-led elimination diet + follow-up£450–£800
Dupilumab (Dupixent) per month£1,000–£1,500

The problem

Allergy and gastroenterology together - because EoE is both.

  • EoE sits between allergy and gastro

    A joint clinic - allergist and gastroenterologist reading the same slides - makes better decisions.

  • Treatment options that actually work

    PPI, topical steroid, elimination diet or dupilumab - chosen with you, not defaulted.

  • Follow-up matters

    Repeat endoscopy is how you know a treatment is working - not just symptom scores.

When it helps

When EoE clinic is the right step.

  • Persistent reflux not responding to PPI

    Especially with dysphagia - a classic EoE presentation.

  • Food impaction

    A stuck bolus of food - a red flag for EoE in older children and adults.

  • Feeding difficulties in a young child

    Slow eating, food aversion, small volumes - sometimes EoE.

  • Chest pain and throat clearing in a teenager

    A less classic but recognised presentation.

  • History of atopy

    Eczema, asthma and hay fever - the atopic march includes EoE for some.

  • Failure to thrive with reflux

    Endoscopy earlier rather than later.

  • On Palforzia OIT with new dysphagia

    A recognised association - worth investigating.

  • Red flag: acute food impaction

    A stuck food bolus not clearing needs same-day endoscopy.

Options

Four evidence-based treatment paths, chosen with the patient.

  • PPI trial (8 weeks)

    First-line for many - up to a third of patients respond fully to PPI alone.

  • Topical swallowed steroid

    Orodispersible budesonide or swallowed fluticasone - high response rates.

  • Six-food elimination diet

    Removing milk, wheat, egg, soya, nuts, fish/shellfish - with dietitic support.

  • One or two-food elimination

    Modern step-up approach starting with milk alone.

  • Dupilumab (Dupixent)

    Weekly biologic - licensed for EoE in patients 12+ years and ≥40 kg.

  • Endoscopic dilatation

    For adults with fibrostenotic disease and true stricture.

  • Endoscopy with biopsy (diagnosis + monitoring)

    The essential test - clinical response alone is not enough.

  • Feeding therapy and psychology

    For children with entrenched food aversion.

Safety and recovery

What to expect - honestly.

  • Diagnosis needs biopsy

    Symptoms alone do not diagnose EoE - always endoscopy with 6+ biopsies.

  • Symptoms can lag behind healing

    Repeat endoscopy is how we know a treatment is working.

  • Topical steroids are safe short-term

    Long-term data are reassuring but oral candidiasis is a risk.

  • Elimination diets are hard

    Dietitic support is essential to protect nutrition and quality of life.

  • Dupilumab in EoE

    Weekly injections; conjunctivitis is the commonest side effect.

  • Dilatation carries perforation risk

    A specialist gastro procedure - rare but real risk.

  • Growth and nutrition in children

    Regular monitoring during any elimination diet.

  • Long-term follow-up

    EoE is a chronic disease - a long-term follow-up plan matters.

  • Red flag: airway swelling, breathlessness or collapse

    Adrenaline first, 999 second. Every family with a diagnosed allergy needs to be clear on this.

Your notes

Your report in four parts.

A UK consultant reviewing notes
  1. Header

    Diagnosis and biopsy findings

    Eosinophil counts per high-power field and endoscopic appearance.

  2. Technique

    Treatment chosen and dose

    PPI, topical steroid, diet or dupilumab and the schedule.

  3. Findings

    Response on repeat endoscopy

    Histological and endoscopic response.

  4. Impression

    Long-term plan and follow-up

    Read this first: your ongoing treatment, next endoscopy and warning signs.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Paediatric allergy is available on the NHS but 6–18 months waits are typical for a first specialist appointment; it is usually covered by private insurers when medically indicated.

Frequently asked

Everything we get asked about EoE clinic.

  • When should EoE be considered?

    When reflux does not respond to standard PPI, when there is dysphagia, food impaction or feeding difficulty, or when a child has slow eating and atopic disease. Diagnosis needs upper GI endoscopy with multiple biopsies showing ≥15 eosinophils per high-power field.

  • What does EoE treatment involve?

    Four evidence-based paths: high-dose PPI for 8 weeks, topical swallowed steroid, targeted food elimination with dietitic support, or dupilumab. Choice depends on age, severity, patient preference and previous response.

  • How much does private EoE care cost in the UK?

    Roughly £350–£600 for a joint clinic consultation, £1,200–£3,800 for diagnostic endoscopy and biopsies (adult vs paediatric), £150–£300 per month for topical steroid, £450–£800 for dietitian-led elimination and £1,000–£1,500 per month for dupilumab.

  • Is EoE care available on the NHS?

    Yes, in adult and paediatric gastroenterology centres with allergy links, but waits for endoscopy and dupilumab access vary widely by region.

  • How long does treatment continue?

    EoE is a chronic disease. Most patients need long-term treatment, whether that is a PPI, topical steroid, ongoing dietary elimination or dupilumab, with regular endoscopic surveillance.

  • Can EoE cause long-term damage?

    Yes - untreated EoE can lead to fibrosis, stricture and food impaction, especially in adults. Treating early and following up properly reduces that risk.

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