Diet and Lifestyle Changes for Patients with EoE
Eosinophilic esophagitis (EoE) is a chronic immune system disease where a type of white blood cell called eosinophils builds up in the lining of the esophagus. This can lead to inflammation, scarring and narrowing of the esophagus, which causes difficulty swallowing and discomfort. One of the most significant factors in managing EoE is identifying and avoiding potential triggers that can cause throat inflammation. Below, we will explore the worst triggers, with foods to avoid with EoE, followed by other contributing factors. We'll also review treatment options available for managing this condition, including Eohilia, a medication that helps relieve symptoms.
1. Foods to Avoid with EoE
Food allergens are among the most common triggers for EoE, and certain foods are notorious for causing throat inflammation in individuals with this condition. The most significant ones include:
- Dairy products: Milk, cheese, yogurt and butter can cause severe allergic reactions in some people with EoE. Dairy proteins are highly allergenic and can provoke an inflammatory response in the esophagus, leading to symptoms like throat discomfort, difficulty swallowing and food impaction.
- Wheat and gluten: Wheat and gluten-containing foods, such as bread, pasta and baked goods, can aggravate EoE symptoms. Gluten is a known allergen that can trigger an immune response, leading to increased eosinophil activity in the esophagus.
- Soy: Soy products, including tofu, soy milk and soy-based foods, are common allergens that can worsen EoE symptoms. Soy proteins may lead to esophageal inflammation in sensitive individuals, contributing to throat irritation and swallowing difficulties.
- Eggs: Eggs are another common allergen that can exacerbate throat inflammation in people with EoE. The proteins in eggs can provoke an immune response, causing eosinophils to accumulate in the esophagus.
- Tree nuts and peanuts: Nuts like almonds, cashews and walnuts, as well as peanuts, can trigger allergic reactions in individuals with EoE. Nut allergies can lead to swelling and inflammation in the throat, making it challenging to swallow.
- Seafood and shellfish: Fish, shrimp, lobster and other shellfish are well-known food allergens that can cause throat inflammation in individuals with EoE. Seafood allergies are often severe, leading to symptoms like throat tightness, pain and difficulty swallowing.
Eliminating these foods from the diet is a key component of managing EoE. Many patients undergo an elimination diet, where potential trigger foods are removed to determine which specific foods are responsible for their symptoms.
2. Environmental Allergens
Environmental factors also play a significant role in triggering EoE flare-ups. Exposure to allergens in the air can worsen throat inflammation and exacerbate EoE symptoms. Common environmental triggers include:
- Pollen: Pollen from trees, grass and weeds can cause allergic reactions in individuals with EoE. When inhaled, pollen can lead to inflammation in the respiratory system, which may extend to the esophagus, aggravating EoE symptoms.
- Pet dander: Pet hair and skin flakes from animals like cats and dogs can trigger allergic reactions in sensitive individuals. Pet dander can cause throat irritation, leading to increased inflammation in the esophagus.
- Dust mites: Dust mites, microscopic organisms found in bedding, carpets and upholstery, are a common cause of allergies. In individuals with EoE, exposure to dust mites can worsen throat inflammation and contribute to difficulty swallowing.
Minimizing exposure to these allergens is essential in managing EoE symptoms. Regular cleaning, using air purifiers and avoiding outdoor activities during high pollen seasons can help reduce the impact of environmental triggers.
3. Acid Reflux
Gastroesophageal reflux disease (GERD), or acid reflux, can also worsen EoE symptoms. When stomach acid flows back into the esophagus, it can cause irritation and inflammation. This can exacerbate the throat discomfort experienced by individuals with EoE. To manage acid reflux, individuals may need to avoid acidic foods such as tomatoes, citrus fruits and spicy foods, as well as reduce caffeine and alcohol intake.
4. Stress and Anxiety
Stress and anxiety can have a profound impact on EoE symptoms. Emotional stress can weaken the immune system and make the body more susceptible to inflammation. Stress-induced inflammation may aggravate throat discomfort and make swallowing more challenging for people with EoE. Managing stress through relaxation techniques, mindfulness and therapy can help minimize its impact on EoE symptoms.
5. Smoking and Air Pollutants
Smoking is a known irritant for the respiratory system, and it can also worsen EoE symptoms. Inhaling smoke from cigarettes, e-cigarettes or even secondhand smoke can cause inflammation in the esophagus and throat. Additionally, exposure to air pollutants, such as smog and chemicals, can further irritate the throat and exacerbate inflammation.
Treatment Options for EoE
While avoiding triggers is essential for managing EoE, treatment options are available to help reduce inflammation and alleviate symptoms. The primary goals of treatment are to prevent further damage to the esophagus and improve the patient's quality of life. Some common treatment options include:
- Eohilia: Eohilia is an oral suspension treatment for EoE. This medication is designed to reduce the buildup of eosinophils in the esophagus, helping to alleviate inflammation and improve symptoms. Eohilia has been shown to be effective in managing EoE, making it an important option for individuals who need additional help controlling their symptoms.
- Dietary management: As mentioned earlier, elimination diets help identify and avoid specific foods that trigger EoE symptoms. Working with an allergist or dietitian can help tailor a diet that minimizes inflammation.
- Proton pump inhibitors (PPIs): PPIs are medications commonly used to reduce acid production in the stomach. By lowering stomach acid levels, PPIs can help minimize acid reflux and reduce inflammation in the esophagus.
- Topical steroids: Swallowed corticosteroids, such as fluticasone or budesonide, can help reduce inflammation in the esophagus. These medications are often used when dietary changes alone do not control symptoms.
Managing EoE requires a multi-faceted approach that includes identifying and avoiding triggers like certain foods, environmental allergens and stress. With proper dietary management and treatment options like Eohilia, individuals with EoE can reduce throat inflammation and improve their quality of life.