Dietary Treatment for Eosinophilic Esophagitis

Are you looking for dietary treatment for eosinophilic esophagitis (EoE)? Well you are in luck. Research suggests there are diet interventions that may help significantly improve this condition.

What is Eosinophilic Esophagitis?

EoE is an inflammatory condition of the esophagus. While the symptoms are similar to general reflux or GERD, it differs in that there is measurable inflammation in the lining of the esophagus which can cause serious damage over time.

It is believe to be caused by certain foods or environmental allergens that trigger this strong inflammatory response.

Symptoms of Eosinophilic Esophagitis

There are many potential symptoms of EoE. Some of these include:

• Acid reflux (heartburn, GERD) or silent reflux
• Chronic cough
• Difficulty swallowing (dysphagia)
• Abdominal pain
• Nausea
• Vomiting
• Chest pain

Diagnosing Eosinophilic Esophagitis

If EoE is suspected, your doctor may order an endoscopy and biopsy to confirm. Or, they may order a barium swallow, which involves ingesting a small amount of dye that can be x-rayed as it travels through the digestive tract. The x-ray will reveal if there are issues with narrowing of the esophagus, swallowing concerns, or other abnormalities.

Dietary Treatment for Eosinophilic Esophagitis

Unfortunately, there are few pharmaceutical treatment options available for EoE. Doctors may prescribe steroids, which are used to quell the inflammation, or proton pump inhibitors, which help reduce reflux. These temporarily alleviate the symptoms but do not cure the condition, making this diagnosis frustrating for many patients.

Often patients have tried these standard treatments and feel stuck in a never-ending cycle of managing symptoms.

Thankfully, we do have researched dietary options for EoE.

Studies have shown there are 6 foods commonly associated with provoking inflammation in this condition. By cutting out these foods and assessing symptoms over time, we can see if certain foods are part of the problem.

6-Food Elimination Diet for Eosinophilic Esophagitis

The 6 food elimination diet is often recommended to help treat EoE.

The 6 foods typically excluded include:

Wheat, dairy, corn, soy, shellfish, peanuts/tree nuts

The elimination diet procedure usually includes these three steps: Eliminate, track, and reintroduce.

Eliminate

Cutting out 6 foods from the diet may not seem overly complicated, but it does get tricky. It involves a lot of label reading, meal planning and close attention to detail. You want to make sure to follow the diet as strictly as possible to get the best read on how these foods may or may not affect you.

Track

It is typically recommended to stay on the elimination diet for 6-8 weeks. This gives enough time for inflammation to come down and symptoms to recede.

As you go through the process, keep a symptom and diet journal to keep track of your dietary choices and any lingering symptoms along the way.

And if you do mess up with a food (ie accidentally eat one of the eliminated items), just note that in the journal. Then get right back on the plan and continue moving forward.

Reintroduce

At some point you will need to reintroduce foods to test their impact on your condition and symptoms. This typically involves adding one food back at a time, with several days in between additions to assess if any symptoms return or get worse.

If a food causes a noticeable symptom, remove that food again from the diet. Wait until the symptom goes away, and then try again with another type of food.

Continue this process until you have reintroduced all of the foods eliminated. Then assess which foods you can safely return to your normal diet and which ones need to stay out for now.

Work with a Registered Dietitian

If choosing to try this type of diet strategy, working with a dietitian is a highly recommended. Food is our specialty! Dietitians are trained in these protocols and can help guide meal planning, review symptoms, and provide ongoing dietary support.

Because at the end of the day, you want to make sure you only have to do this diet once. Do it right and get the answers you need.

Other Dietary Approaches for Eosinophilic Esophagitis?

If a 6-food elimination diet seems daunting, there’s newer research that suggests a less strict protocol may work just as well.

Simply eliminating one food type, according to research, may be just as effective as a full-fledged, multi-food elimination diet.

Also, while an elimination diet works for many patients, do note that it does not work for everyone. For some, the triggers foods are beyond the 6-food elimination diet.

For clients who do not respond to an elimination diet, food sensitivity testing may be a reasonable next step. My practice uses the Mediator Release Test (MRT) to help uncover hidden sensitivities that are not addressed by a common elimination diet.

MRT is an incredible tools that allows us to devise the perfect, customized elimination diet. Often this helps us close the loop on undiscovered food triggers and finally find success in reducing inflammatory levels and symptoms.

Summary

Have you been diagnosed with EoE or your doctor suspects it? Reach out to a dietitian if you need help figuring out the right dietary treatment for eosinophilic esophagitis. Any new diet protocol is always easier and more successful with a little guidance!

Recipe of the Month: Buckwheat Waffles

If you are getting started on an elimination diet or just want to try something gluten- and dairy-free, these waffles are a winner!

Food Sense Nutrition’s Buckwheat Waffles

Try these delicious, high-fiber waffles you can whip up in minutes. Buckwheat flour is pretty easy to find at most major grocery stores or online at Amazon or Thrive Market.