Adults can present with all of the same EoE symptoms seen in older children and adolescents. However, it does appear that impaction episodes with foods becoming lodged in the esophagus can become more common in adults. These food impactions often need urgent intervention by a gastroenterologist or surgeon to endoscopically remove the food bolus. Very often the diagnosis is first raised after a first impaction episode has occurred and esophageal biopsies taken at the time reveal significant eosinophilic inflammation.

Now whether adults who are initially diagnosed with EoE represent new onset of this disease or chronic disease that had gone undiagnosed throughout their childhood remains unclear. When patients who were diagnosed with EoE as adults are questioned about prior symptoms, some can identify possible EoE symptoms going back to childhood whereas other clearly describe start of their symptoms in adulthood.