There are medical and lifestyle adjustments that can help manage both allergies and EoE symptoms.
First, you need to identify the culprit foods and avoid them. “Elimination diets are often the first-line treatment,” says Dr. Huang. You’ll probably start by eliminating common allergens (egg, nuts, soy, etc.) from your diet. Your gastroenterologist will then perform a biopsy of your esophagus to see if the inflammation is under control. If so, you can slowly introduce foods back into the diet. Once you know the cause, it’s best to avoid them completely.
Milk and wheat are also common triggers for EoE and can contribute to fecal impaction caused by food getting stuck in the esophagus, so it’s best to eliminate these foods as well. In fact, a recent study found that when EoE patients eliminated milk from their diet, their esophageal symptoms decreased by 34 percent.
If you have environmental allergens, it is also important to take steps to address them, although this may not have a direct impact on your esophageal symptoms. A good first step is to see an allergist to narrow down the exact allergy. Discuss whether you should get allergy shots or take antihistamines regularly.
If your EoE tends to be exacerbated by seasonal allergies, check the pollen counts in your area and avoid being outdoors on days with high pollen counts. If possible, keep windows closed (pollen can come in through open windows and doors), shower at night to remove pollen from your body before bed, and avoid breathing in pollen all night.
Finally, talk to your doctor about your symptoms to determine whether your current medications are appropriate or need adjustment. EoE and its associated symptoms are highly variable and can quickly become severe, so it is important to have the correct diagnosis and treatment plan.