Gastroenterology · Allergy and Immunology

Index of Severity for Eosinophilic Esophagitis (I-SEE) calculator

Enter the published formula inputs below to calculate and interpret this score.

Clinical inputs

Age

years

Allowed range: 0–120 years

Age 18 or older uses the adult food-impaction and dilation points. Under 18 uses the child points.

Symptoms

Weekly is 1, daily is 2, and several times a day or disrupted social function is 4. Count symptoms since the last visit.

Food impaction needing an emergency visit or endoscopy

This feature is 2 points at age 18 or older and 4 points under 18.

Hospital stay caused by eosinophilic esophagitis

Esophageal perforation

Malnutrition or falling growth

Body mass under the 5th percentile or a decreased growth trajectory scores 15.

Persistent inflammation needing elemental formula, systemic corticosteroid, or immunomodulatory treatment

This feature scores 15 and is added to perforation and malnutrition when more than one is present.

Inflammatory endoscopy

Edema, furrows, or exudates: localized is 1 and diffuse is 2. Use the worst finding in the esophagus.

Peak eosinophil count

eos/hpf

Allowed range: 0–500 eos/hpf

Under 15 per high-power field is 0, 15 through 60 is 1, and above 60 is 2.

Fibrostenotic endoscopy

Easy passage is 1 and a snug fit is 2. A single dilation is 2 at age 18 or older and 15 under 18. Inability to pass, repeated dilations at age 18 or older, or any dilation under 18 is 15.

Basal zone hyperplasia or lamina propria fibrosis

Either finding scores 2 once. If lamina propria is absent, dyskeratotic epithelial cells or surface epithelial alteration stand in for fibrosis and also score 2 once.

Result

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Primary source

Dellon ES et al. A clinical severity index for eosinophilic esophagitis: development, consensus, and future directions. Gastroenterology. DOI: 10.1053/j.gastro.2022.03.025. PMID: 35606197. Table 1: symptoms weekly 1, daily 2, and multiple times per day or disrupting social functioning 4. Complications add: food impaction with an emergency visit or endoscopy is 2 at age 18 or older and 4 under 18; hospitalization for eosinophilic esophagitis is 4; esophageal perforation, malnutrition with body mass under the 5th percentile or a falling growth trajectory, and persistent inflammation requiring an elemental formula, systemic corticosteroid, or immunomodulatory treatment are 15 each. Inflammatory endoscopy is localized 1 or diffuse 2. Peak eosinophils 15–60 per high-power field are 1 and above 60 are 2. Fibrostenotic endoscopy is 1 when the endoscope passes easily, 2 for a snug fit or a single dilation when the patient is 18 or older and the severe category does not apply, and 15 when a standard endoscope cannot pass, dilations are repeated at age 18 or older, or any dilation is done under age 18. Basal zone hyperplasia or lamina propria fibrosis, or dyskeratotic epithelial cells or surface epithelial alteration when lamina propria is absent, is 2. For a box with more than one feature, each selected feature scores. Total under 1 is inactive, 1–6 mild active, 7–14 moderate active, and 15 or higher severe active. Table 2 examples total 4, 24, and 11. (2022)

Scope: Patients with eosinophilic esophagitis, scored at diagnosis and again at each visit using findings since the previous visit. Diagnosis itself requires isolated esophageal eosinophilia of at least 15 eosinophils per high-power field after other causes are excluded.

Last reviewed 2026-10-17

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Professional use only

For qualified clinicians. Independently verify inputs, calculations, source guidance, and applicability before any clinical action. This calculator does not replace clinical judgment.

Source: Dellon ES et al. A clinical severity index for eosinophilic esophagitis: development, consensus, and future directions. Gastroenterology. DOI: 10.1053/j.gastro.2022.03.025. PMID: 35606197. Table 1: symptoms weekly 1, daily 2, and multiple times per day or disrupting social functioning 4. Complications add: food impaction with an emergency visit or endoscopy is 2 at age 18 or older and 4 under 18; hospitalization for eosinophilic esophagitis is 4; esophageal perforation, malnutrition with body mass under the 5th percentile or a falling growth trajectory, and persistent inflammation requiring an elemental formula, systemic corticosteroid, or immunomodulatory treatment are 15 each. Inflammatory endoscopy is localized 1 or diffuse 2. Peak eosinophils 15–60 per high-power field are 1 and above 60 are 2. Fibrostenotic endoscopy is 1 when the endoscope passes easily, 2 for a snug fit or a single dilation when the patient is 18 or older and the severe category does not apply, and 15 when a standard endoscope cannot pass, dilations are repeated at age 18 or older, or any dilation is done under age 18. Basal zone hyperplasia or lamina propria fibrosis, or dyskeratotic epithelial cells or surface epithelial alteration when lamina propria is absent, is 2. For a box with more than one feature, each selected feature scores. Total under 1 is inactive, 1–6 mild active, 7–14 moderate active, and 15 or higher severe active. Table 2 examples total 4, 24, and 11. (2022)

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Clinical inputs

Age (years)Accepted range: 0 to 120
Symptoms
Food impaction needing an emergency visit or endoscopy
Hospital stay caused by eosinophilic esophagitis
Esophageal perforation
Malnutrition or falling growth
Persistent inflammation needing elemental formula, systemic corticosteroid, or immunomodulatory treatment
Inflammatory endoscopy
Peak eosinophil count (eos/hpf)Accepted range: 0 to 500
Fibrostenotic endoscopy
Basal zone hyperplasia or lamina propria fibrosis

Primary source

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