Eosinophilic esophagitis (EoE) is an inflammatory condition that primarily affects one’s esophagus. The condition may not lead to life-threatening health complications, but it affects one’s overall quality of life. The exact cause of EoE is not fully understood, but it is believed to be related to an abnormal immune response to certain allergens. Understanding the cause, triggers, symptoms, and treatment options for EoE is important for timely intervention and maintenance of one’s esophageal health.

What is eosinophilic esophagitis?
The esophagus is a tube-like part of the human body responsible for guiding food from the mouth to the stomach during digestion. Certain individuals may have a chronic immune response to certain allergens and develop this condition. EoE is characterized by the presence of a high number of white blood cells called eosinophils in the lining of the esophagus. This unexpected presence of eosinophils can lead to inflammation and irritation of the esophagus, resulting in difficulties like trouble swallowing, chest discomfort, and food blockages.

Foods to avoid for EoE
Finding and eliminating foods that worsen symptoms is a common strategy used for managing eosinophilic esophagitis. This may involve removing specific items from one’s eating habits and slowly reintroducing them to identify the triggers. Here are the food triggers commonly eliminated:

Milk
Cow’s milk and dairy products, including cheese, yogurt, and butter, are frequently identified as triggers for eosinophilic esophagitis. The proteins present in milk, such as casein and whey, are known allergens that can stimulate an immune response in the esophagus, leading to inflammation and symptoms like difficulty swallowing and chest pain. Doctors may recommend some diary alternatives to EoE individuals.

Eggs
Eggs, whether consumed in their whole form or as ingredients in various culinary preparations, can pose challenges for individuals grappling with EoE. Dishes like omelets, scrambled eggs, and baked goods containing eggs are potential sources of symptom exacerbation. The proteins found in eggs, particularly in egg whites, can trigger an allergic response in the esophagus.

Wheat
Wheat and wheat-derived products, including bread, pasta, cereals, and baked goods, have been associated with the aggravation of EoE symptoms. Wheat is a significant source of gluten, a protein that some individuals with EoE are sensitive to. Gluten consumption can contribute to inflammation in the esophagus, leading to discomfort and difficulty swallowing.

Soy
Soy and soy-based products, such as soy milk, tofu, and soy sauce, have the potential to act as triggers for EoE. These items contain proteins that may induce an immune response in the esophagus, resulting in inflammation and related symptoms. So, individuals with EoE might find it necessary to exclude soy to maintain their vulnerable esophageal health.

Fish and shellfish
Certain types of fish, such as tuna, salmon, and cod, can act as triggers for EoE in susceptible individuals. This also includes shellfish, encompassing many varieties like crayfish, shrimp, crab, lobster, oysters, clams, mussels, and scallops. These are also recognized as allergenic foods that worsen EoE symptoms in some individuals. The proteins in shellfish can lead to inflammation and swallowing difficulties. It’s best to exercise caution or avoid shellfish altogether to minimize the risk of symptom flare-ups.

Tree nuts and peanuts
Various tree nuts, including almonds, walnuts, pecans, and cashews, are potential triggers for individuals with EoE. Similarly, despite being legumes, peanuts and peanut oil are also considered a common allergenic food. Nut-containing products and spreads may also cause symptom recurrence and are best eliminated until one’s doctor finds out the exact trigger of one’s condition.

Processed and packaged foods
Many processed and packaged foods may contain hidden allergenic ingredients or food additives that can develop EoE symptoms. It is essential to diligently read food labels and ingredient lists to identify and avoid products that contain known trigger foods. This cautious approach to food selection can help individuals with EoE maintain symptom control and esophageal health.

Foods to eat for EoE
The range of foods that are typically well-tolerated by individuals with EoE is extensive and includes:

White and sweet potatoes.
A wide range of fruits and vegetables.
Alternative grains like quinoa, buckwheat, and millet.
Healthy oils such as olive oil, sunflower oil, and canola oil.
Varieties of rice like white, brown, and wild rice.
Different types of meat such as chicken, turkey, pork, and beef.

Aside from the nutritional dos and don’ts for EoE, it is vital for one to know the causes and symptoms of the condition.

Causes of EoE
The exact cause of eosinophilic esophagitis is not fully understood, but it is believed to be related to a combination of genetic, environmental, and immune system factors. Common environmental allergens may include dust, mites, or pollen, which triggers an immune response in the body. Some people with a family history of allergic conditions like asthma or eczema may also be at risk.

Symptoms of EoE
The symptoms of EoE are very similar to Gastroesophageal Reflux Disease (GERD), which is a condition marked by acid refluxes. Other symptoms include:

Difficulty swallowing
Food getting stuck in the esophagus
Chest pain
Heartburn
Regurgitation
Nausea and vomiting

In children, EoE can lead to feeding difficulties, slow growth, and recurrent abdominal pain.

In addition to using food to help manage the symptoms of the condition, one can opt for several remedies, treatments, and lifestyle changes to deal with EoE.

Remedies and treatments for eosinophilic esophagitis
The primary goal of EoE treatment is to reduce inflammation in the esophagus and alleviate symptoms using various methods. Food elimination is considered to be the most common method, but there are other treatment options that can be helpful. These are as follows:

Home remedies
Gargling with warm salt water may offer temporary relief for throat irritation. Licorice and chamomile may also be used for their potential anti-inflammatory and soothing properties to temporarily relieve acid reflux in EoE individuals.

General habits
Adopting certain habits like eating smaller bites and meal sizes, having more frequent meals, and chewing food thoroughly can ease the process of swallowing and reduce discomfort. However, it’s crucial to consult with a healthcare provider for a proper diagnosis and to discuss treatment options tailored to your specific case

Acid reduction therapy
Some individuals benefit from treatments that decrease stomach acid production, as acid reflux can exacerbate symptoms.

Inflammatory response control
Managing the body’s immune response to inflammation in the esophagus is crucial. One can consult a doctor to learn about the methods that can be used to regulate this response.

Esophageal dilation
In cases where EoE has led to esophageal narrowing that hinder swallowing, a specialized treatment can be performed to widen the esophagus.

Regular monitoring
Consistent follow-up appointments and periodic endoscopic evaluations may be necessary to gauge the effectiveness of treatment, detect any issues, and adjust the management plan accordingly.

Nutritional support
For individuals who must exclude multiple trigger foods, working with a nutritionist can help maintain a well-balanced and nourishing food intake. Some additional supportive treatments may also be suggested to avoid nutrient deficiencies.