Better treatment of EoE – Can someone tell if his or her eosinophilic esophagitis (EoE) is better?

How do we know if someone with eosinophilic esophagitis (EoE) is improving  with an elimination diet or medications. Is just feeling better an accurate way to tell?

A study (CE Kuehni and others, Gastro 2016; pages 581-90, recruited 269 adults in Switzerland and the U.S between 2011 and 2014. The average age was 39 years old. One hundred eleven (111, 41%) said they felt wonderful, with no symptoms at all. But when an endoscopy was done, only 79 (72%) looked to be normal and only 75 (68%) reached what's called a histologic remission, where the eosinophils have vanished and there's less likelihood of the esophagus scarring later. 

Bottom line:  The lack of symptoms does not mean that the disease is "in remission." Some activity may be continuing and for the time being, the only way to tell is to be guided by biopsies. This is true in this adult study and I suspect, it is probably true for kids as well.