It might sound counterintuitive, but people with longer term severe Eosinophilic Esophagitis have more of an issue with minor allergies than the things that cause major allergies. Here’s why…
In EoE there is a gradual build up of white blood cells called Eosinophils. This is what causes the inflammation and closing of the esophagus. Typically EoE suffers have food (or other) allergies that cause a MAJOR reaction, and other allergies that cause MINOR reactions. Below are the reasons that minor allergies are more of the reason EoE is difficult to push into remission.
- Things that cause major allergic reactions are identified easily, because they cause an obvious reaction and the sufferer knows they should stay away from those things. And they do, so the affect of that allergen is short lived.
- Things that cause minor reaction most times go unnoticed to the observer, ALTHOUGH there is still a reaction in the esophagus in that more eosinophils are produced to react more to even the minor allergen. So the EoE sufferer can’t even tell that their body is reacting until it causes the esophagus to close so much that it’s hard to swallow.
- Food allergy tests are not able to definitively determine which allergens are causing the EoE reaction. They can identify a food allergy, but that does not equate to which ones are triggers for the EoE reaction.
So the culprit in Eosinophilic Esophagitis is the continued exposure to allergens that fly under the radar. The ones that the person doesn’t notice.
THAT is why EoE is so hard to beat. Because those allergens are so hard to identify and eliminate. It could be ANYTHING. It could be a frequent food, a spice, a common ingredient, whatever. Elimination diets work when the person can find the needle in the haystack that, when removed, results in improved condition. Even this takes weeks for every trial food to see if they can feel relief. Very difficult to do for most EoE sufferers.
All this being said, the limited recommended options to figure out your EoE are these:
- Get both blood allergy and skin tests to identify which things are strong positives for allergens. Then avoid these for a period to see if conditions improve.
- Keep track of everything you eat and pay attention over time to how you respond. It’s difficult because conditions don’t change overnight. It might take weeks of avoiding and paying attention to foods to see if you can tell improvement. It takes diligence, because it’s a difficult disease.