The incidence of EoE among children in the NDR in 2007–2017 was much lower than expected. The incidence in similar studies in Europe is more than six times higher [
8]. The incidence among children in the only other study in Denmark was calculated in 2008 [
10] and was two times higher than the incidence calculated in this study. As the incidence of EoE has been documented to increase in the entire western world, the low incidence found in the present study is most likely due to lack of detection. Our group found a 50-fold increase in EoE among adults in NDR in 2007–2017, following the introduction of a new biopsy protocol in 2011 [
9]. Accoding to this protocol, all patients with dysphagia should have sampled at least eight biopsies regardless of macroscopic findings. This single intervention resulting in such a dramatic increase in incidence suggests that the awareness of EoE in NDR had been low. Moreover, the incidence of EoE reported in other European countries is very similar among adults and children [
8]. The incidence found in this study was eight times lower in children compared to adults suggesting that not all children with EoE are diagnosed in NDR. Additionally, the male:female ratio of 17:1 and the lack of children aged 0–2 diagnosed with EoE in our study population differed from the literature. Spergel et al. 2009 included 620 children and found a male:female ratio of 3:1 [
15], which is consistent with what has been reported in adults in NDR [
16]. Furthermore, the results by Spergel et al. showed that 35% of children with EoE are diagnosed before the age of three and 68% before the age of 6 [
15]. This suggests that many children with EoE aged 0–2 years are not found in NDR despite suffering from the disease [
3,
15]. Regarding complications, food impaction was overrepresented in our study population compared to the literature [
4]. This suggests that the children were diagnosed late, since food impaction is a late-stage manifestation of EoE [
17]. We speculate that the diagnosis of EoE in these children was not considered until complications emerged, which may be explained by diffuse symptoms such as vomiting and abdominal pain being harder to attribute to the oesophagus and thus less likely to be associated with EoE.