Eosinophilic esophagitis (EE) is a disease diagnosed using both clinical and pathologic results. Presentation varies among age groups with younger children suffering from vomiting, failure to thrive, or food refusal and adolescents suffering from dysphagia, odynophagia, or food impaction. It is more prevalent in males. EE is suggested when an upper endoscopy yields eosinophils greater than 15 per high power field (hpf) in both the middle and distal esophagus. Therapy for EE depends upon age and ability to be compliant. Three main categories of treatment are options for families, including the use of medicines, removal of the most allergenic foods, and the use of an elemental diet (formula) (1-2). Treatment can be different within the two main phases of therapy for EE, initial and maintenance therapy. Initial therapy occurs when the patient is first diagnosed and has eosinophils over 15 per hpf and can last for years if the patient does not respond to treatment. Maintenance therapy only occurs after the patient has responded to treatment with a reduction of his/her eosinophil counts below 5 per hpf. Typically, medicinal therapy with steroids (either oral prednisone or swallowed fluticasone) improves eosinophil counts but has a large side effect profile suggesting that steroids are not ideal for maintenance therapy. Dietary therapies are effective in both treatment phases but many patients find it difficult to remain compliant with food restriction for a prolonged length of time. Unfortunately, EE recurs upon withdrawal of oral therapy (3-7).