When should I consider referring a patient with eosinophilic oesophagi

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

When to consider referring a patient with eosinophilic oesophagitis (EoE) to a specialist:

For children and young people, consider referral to a paediatrician or paediatric gastroenterologist if there is an uncertain diagnosis or atypical gastro-oesophageal symptoms . Referral is also indicated if there are "red flag" features, or if symptoms are not responding to, or needing ongoing treatment .
Specific considerations for referral to secondary or specialist care in children and young people that may be relevant to EoE include faltering growth combined with gastrointestinal symptoms, symptoms not responding to a single-allergen elimination diet, or a clinical suspicion of multiple food allergies .
For adults, referral to a specialist service (gastroenterologist or upper gastrointestinal surgeon) should be considered for gastro-oesophageal symptoms that are non-responsive to treatment, persistent, or unexplained ,.

When should I consider referring a patient with eosinophilic oesophagitis to a specialist?