EOE, or Eosinophilic esophagitis– white blood cells in the esophagus – my methods for treatment, and how it links to inflammation
Thirteen years ago – I am a third grader at a sleepover in elementary school. We are all up late at night, and my friend Charles wants to grab an apple from the counter. I go along with him and grab one myself. Even though I have food sensitivities, I am hungry and really enjoy apples. However, this time I eat it and it doesn’t go down my throat. I panic as I try to drink water to wash the food down, and instead of the food going down my throat, the lodged apple prevents water from going down, causing me to choke. My friend’s mother gives me the Heimlich maneuver to force the apple from my throat. This was the first time I discovered I had EOE.
What is EOE?
Eosinophilic esophagitis is a chronic, allergic inflammatory disease in which white blood cells (called eosinophils in this case) accumulate in the esophagus. Given their nature, white blood cells are primarily found within the blood and lymph tissue, and naturally should not be traced to the esophagus.
Eoe is similar to any food sensitivity or allergy you may have – it is inflammation caused by a misinterpretation of a threat to the body’s immune system. Unlike a traditional allergy, over time, the immune system builds a wall of white blood cells within the esophagus. These white blood cells constrict the throat and cause it to be come stiff and rigid over time, so that when you eat, swallowing becomes a hard if not impossible task. Food gets easily lodged in the throat and sometimes the only way to get it back out is through surgery.
I’ve had around 7-9 endoscopies (I lost count after 5). During these 30-minute procedures, my doctor puts a scope down my esophagus, whether it be to get something out of my throat or to monitor the status of how my body has reacted to the foods I’ve been eating. Over time, I’ve learned different ways to deal with the disease and better practices to help mitigate my symptoms.
For me, EOE was caused by two things:
- An allergic response to certain food types (mainly dairy)
- Stress. Whenever I was stressed, my EOE flared up (the mind-body connection is a powerful thing).
How do you treat EOE?
Currently, the medical community has three primary treatment options for EOE:
- Go on elimination diets until you can target a food group that is causing the inflammation (i.e. milk, wheat, eggs etc). From there, eliminate those food(s) completely from your diet.
- Take a steroid and anti-acid for as long as you live. This may be either a Flovent (swallowed powder-like steroid) or a fluid such as budesonide. With this, there are obvious side-effects.
- Dilate the esophagus through surgery. My uncle has had this, and it essentially entails inserting a balloon-like object into your esophagus and inflate it. The result – a stretched esophagus that will make swallowing easier (for now).
EOE, however, is a newly discovered disease, so new treatment options appear to be on the horizon. In fact, it was just this June that scientists discovered a possible protein responsible for triggering cytokines in the esophagus which can be treated using a drug for emphysema.
What worked for me?
I have tried the first 2 treatment options, but do not see a reason for the third. Throughout my senior years of both high school and college, I attempted elimination diets and subsequently tried to stay away from the steroids and acid reducers due to the poor side effects. I have found the elimination diets to be helpful, given that my EOE comes back if I eat regular food. Over the course of 6 different elimination diets, I have found 2 to work.
The two diets that have prevented my EOE are the following:
An “elemental diet”: A diet consisting of nothing but feeding tube material (and a handful of fruits and veggies). This diet is the barest of bare – I lost 15 pounds over the course of 8 weeks due to the lack of calories (and I was never really fat to begin with). In terms of results, this diet helped reveal that my allergy was in fact not airborne, but was a product of the food I ate.
- GAPS Diet: writing this, I have been on the GAPS diet for about 2 months now and am still on it. Not only have my symptoms gone away, but I haven’t had to use anti-acids either. I would highly recommend giving this remarkable diet a try if you are indeed diagnosed with EOE – both my food sensitivities and my EOE symptoms have significantly improved. You can learn more about the GAPS diet here.