Infants can be the most challenging age group to make the diagnosis of eosinophilic esophagitis since babies cannot describe the symptoms they are experiencing.
Frequent vomiting is a very common symptom of EE in babies. It can occur with every meal or several times throughout the day and night. Acid reflux disease, also known as gastroesophageal reflux disease (GERD,) also presents with frequent vomiting, so it can be quite difficult to tell the difference between a severe case of acid reflux and EE. Howeve, acid reflux disease is a much more common condition seen in infants so it usually is the first diagnosis that should be considered. One clue that your baby’s vomiting is due to eosinophilic esophagitis rather that GERD is that EE should not respond to anti-reflux medications. Common anti-reflux drugs include H2 Blockers such as ranitidine (Zantac) or cimetidine (Pepcid) and Proton Pump Inhibitors (PPIs) such as such as omeprazole (Prilosec) or lansoprazole (Prevacid).
Additional EE symptoms in infants may be more subtle and can include issues such as chronic cough, feeding refusal, slow weight gain or may be a more significant failure to thrive. Concerning signs would be a drop in weight percentiles for age. Similar to vomiting, there are other more common causes of weight and feeding issues so EE should not necessarily be considered first as a possible diagnosis.