What is Eosinophilic Esophagitis?
Eosinophilic esophagitis (EoE) is a chronic immune system disease in which eosinophils, a type of white blood cell, build up in the esophagus. This can lead to inflammation, tissue damage and difficulty swallowing. Treatments such as Eohilia (dupilumab) are available, which help reduce inflammation and improve symptoms. Dietary management is also crucial for those with EoE, as certain foods can trigger or worsen symptoms. Understanding which foods to avoid is key to managing this condition effectively.
Common Foods to Avoid with Eosinophilic Esophagitis
1. Dairy Products
Dairy is one of the most common triggers for EoE. Milk, cheese, yogurt and other dairy products contain proteins like casein and whey, which can provoke an immune response in individuals with EoE. These proteins in the esophagus can lead to inflammation, causing symptoms such as difficulty swallowing, chest pain and food impaction.
2. Wheat
Wheat is another common allergen associated with EoE. The gluten and other proteins found in wheat can trigger an immune response in the esophagus, leading to increased eosinophil activity and inflammation. Consuming wheat can cause significant discomfort, including difficulty swallowing and pain. Eliminating wheat from the diet can help manage symptoms.
3. Soy
Soybeans and soy-based products are also known triggers for EoE. Soy proteins can lead to an overproduction of eosinophils in the esophagus, contributing to inflammation and damage to the esophageal lining. This can lead to to increased pain and difficulty eating.
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4. Eggs
Eggs are another common food allergen that can trigger EoE symptoms in some people. The proteins in egg whites, such as ovalbumin, are often the culprits behind the allergic response. Eating eggs can lead to inflammation and symptoms like chest pain and difficulty swallowing. Removing eggs from the diet is essential for managing EoE.
5. Nuts and Peanuts
Nuts and peanuts are potent allergens that can trigger EoE symptoms. The proteins found in nuts can cause inflammation and other EoE-related symptoms. Consuming nuts can cause significant discomfort for those with EoE. Avoiding nuts is critical to prevent flare-ups and manage the condition effectively.
Other Common Triggers
In addition to the foods mentioned above, other common triggers for EoE can include:
- Seafood and shellfish: These are common allergens that can exacerbate EoE symptoms.
- Corn: Some individuals with EoE may react to corn or corn-based products.
- Beef: Although less common, beef can trigger symptoms in some people with EoE.
- Food additives: Certain food additives, such as artificial colors and preservatives, may also trigger EoE symptoms.
Treatment Options for Eosinophilic Esophagitis
Managing EoE typically involves a combination of dietary changes, medications and in some cases, medical procedures. The goal of treatment is to reduce inflammation, alleviate symptoms and prevent long-term complications.
1. Dietary Management
Elimination diets are often the first line of treatment for EoE. By systematically removing common allergens like dairy, wheat, soy, eggs, nuts and seafood from the diet, individuals can identify specific triggers and reduce symptoms. Once triggers are identified, a long-term dietary plan can be developed to avoid these foods.
2. Medications
Medications play a significant role in managing EoE. Commonly prescribed medications include:
- Proton pump inhibitors (PPIs): These medications reduce stomach acid production, which can help decrease inflammation in the esophagus.
- Topical steroids: Swallowed steroids, such as fluticasone or budesonide, can be used to reduce eosinophil counts and inflammation in the esophagus.
- Eohilia (dupilumab): This is a newer treatment option for EoE. It is a monoclonal antibody that targets the interleukin-4 receptor, reducing inflammation associated with eosinophilic activity. Clinical trials have shown that Eohilia can significantly reduce eosinophil counts in the esophagus, improve symptoms and enhance the quality of life for individuals with EoE.
4. Dilation
In cases where the esophagus has become narrowed due to inflammation and scarring, esophageal dilation may be necessary. This procedure involves stretching the esophagus to improve swallowing and reduce discomfort.
