What exactly is EOE?
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Questions and answers
While food and environmental allergies often trigger an inflammatory immune response, the inflammation of the esophagus in this condition is caused by a white blood cell called an eosinophil. We all have eosinophils, and while this white blood cell is good and known to fight off parasites and play a role in other immune system functions, the issue is when an accumulation of these cells congregate in the GI tract.
What are the typical symptoms?
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How is a diagnosis made?
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The only way to test for EOE is to take a biopsy of esophageal tissue and have it examined to see how many eosinophils are present. Just like anything in the body, it ebbs and flows, which is why it’s important to get a variety of biopsies in various locations of the esophagus to present a more accurate picture of what’s going on. This requires an upper endoscopy to be done, which often requires sedation. They have come out with a procedure now that allows you to be awake through an endoscopy, though not all Gastroenterologists practice or offer this method at this time.
Ideally, the pathology report should show 0-15 eosinophils in a given location. If the number is higher than 15 eosinophils, EOE is considered to be active and an EOE diagnosis is made.
What happens when you have EOE
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EOE isn’t something a child or adult can “grow out of.” Instead, it goes in and out of remission, but is a lifelong condition that must be dealt with to lessen the amount of scar tissue that can form from chronic inflammation. When scar tissue forms and thickens, that’s when food can become difficult or impossible to swallow. While the person can still breathe, no food can pass up or down the esophagus until the blockage is removed - either by forcing it down with pressure, throwing it up, or removing it surgically.
To say the sensation is uncomfortable is an understatement, and it can be downright painful. As food backs up due to the blockage, vomiting can start as food hits your gag reflex.
Managing EOE
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So how do you manage this condition?
Typical conventional medicine ways include elimination diets (removing the foods causing the inflammation) and/or the use of medicines such as swallowed steroids or Proton Pump Inhibitors (PPIs) to keep the eosinophils at bay.
Many people are able to remove milk from their diet (the top food that causes EOE) and they are good to go. For others, however, it’s far more complex, and finding food or environmental triggers can be difficult or impossible to figure out.
To manage EOE, most patients have a team of doctors including a gastroenterologist, nutritionist and an allergist to help manage and alleviate symptoms. Additional team members can include feeding & speech therapists (mostly for children), endocrinologists, and dermatologists, as eczema can often be a symptom as well. These are all in addition to a regular doctor or pediatrician.
Our Story
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And while all of these are methods that work for many patients of EOE, our story has led us in a different direction because conventional ways of dealing with EOE just haven’t worked for us. While we’ve been able to achieve remission a few times using the methods described above, it’s never been anything sustainable or something that allowed us a sustainable quality of life.
To read more about our story and our approach to EOE, click here (page coming soon!)
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