Which diagnostic tests are recommended for confirming eosinophilic oesophagitis in primary care?

The provided UK guidelines do not specify diagnostic tests recommended for confirming eosinophilic oesophagitis in primary care ¹,²,³.

The guidelines primarily focus on the assessment and diagnosis of food allergies in children and young people ¹,²,³. For suspected IgE-mediated food allergy, an allergy-focused clinical history and physical examination are crucial ¹. Diagnostic tests that may be offered include skin prick tests and/or blood tests for specific IgE antibodies to suspected foods ¹,²,³. These tests should only be undertaken by healthcare professionals with appropriate competencies to select, perform, and interpret them ¹,²,³. Skin prick tests require facilities to manage an anaphylactic reaction ¹. Serum-specific IgE testing is widely available, but results are not immediate ²,³. It is important to interpret test results in the context of the clinical history, as allergy testing cannot distinguish between sensitization and clinical allergy ²,³.

For suspected non-IgE-mediated food allergy, a trial elimination of the suspected allergen (typically 2–6 weeks) followed by reintroduction is suggested, with advice from a dietitian ¹.

Oral food challenges are considered the gold standard for confirming food allergy but are not recommended for diagnosing IgE-mediated food allergy in primary care or community settings ¹,²,³.