Eosinophilic esophagitis (EE or EoE) symptoms can be identical to those seen in acid reflux so there is no single sign or symptom that can reliably differentiate EE from Gastroesophageal Reflux Disease (GERD). Therefore, confirming the diagnosis of EE and ruling out acid reflux disease is the critical first step since treatment for GERD is much more straightforward. Furthermore, untreated reflux disease, like EE, can also result in significant inflammation with eosinophils seen on biopsies taken during an upper endoscopy (EGD) due to acid from the stomach rising up or “refluxing” into the esophagus.
One last point is that less common causes of esophageal eosinophilia should also be ruled out such as drug allergies, parasitic infection, or hypereosinophilic infections. Therefore your doctor should consider and evaluate when indicated for these other possible conditions.