People with EoE often find that their quality of life is affected by their symptoms. However, there are many treatment methods that may improve your symptoms and help you swallow easier. Keep reading to discover how we treat EoE.
Diagnosing EoE
Eosinophilic oesophagitis (EoE) causes difficulty swallowing, weight loss, and heartburn. To diagnose EoE, we perform an upper endoscopy and take multiple biopsies (small tissue samples).
We take these biopsies from the lining of your food pipe, also known as your oesophagus or gullet. Read our blog to learn more: How does a private endoscopy for eosinophilic oesophagitis (EoE) work?
We also might recommend a barium swallow test to assess your upper gastrointestinal tract and allergy testing to confirm a suspected allergy. Your test results and the symptoms you are experiencing will influence our treatment recommendations.
Allergy testing
Many people with EoE have an allergic disorder, such as asthma, eczema, and food allergies. If your symptoms worsen when the pollen count is high, you may be experiencing environmental allergies. You might want to undergo testing for common environmental allergies such as animals, dust mites, and pollen to determine this.
EoE treatment
EoE treatment methods include dietary treatment and medications. Though, there is no complete cure. Left untreated, EoE could lead to oesophageal narrowing and scarring. If your oesophagus (food pipe) narrows, we can treat this with endoscopic dilatation.
Watch Dr Sami, our Consultant Gastroenterologist, explain how we diagnose and treat EoE in our video below.
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We understand that EoE can have a psychological impact as well as a physical one. Read our blog to hear the experiences of others with EoE: Your EoE Stories: Treating eosinophilic oesophagitis. Getting the right treatment can help you eat easier and improve your overall quality of life.
Dietary treatment
If we identify foods that trigger your EoE symptoms, the first step will be to remove these from your diet. To determine which foods are causing a reaction, we may recommend a two, four or six-food elimination diet.
During an elimination diet, you cut out several foods that commonly cause allergic reactions. If your treatment plan involves removing foods from your diet, we recommend seeing a dietician.
A dietician can help you manage your new diet as it can be hard to maintain. They can suggest alternative foods to prevent losing nutrients and may also recommend using supplements. If you feel better after an elimination diet, you might be able to reintroduce some foods one at a time.
Elimination diet
Removing trigger foods from your diet can improve redness and inflammation in your food pipe. Dairy and wheat products are often the first foods to eliminate. If you still experience EoE symptoms, you may move on to a four or six-food elimination diet.
Six common allergens include
- Dairy products
- Fish/shellfish
- Wheat
- Eggs
- Soya
- Nuts
Some people also benefit from removing rice and legumes from their diet. Though, restricting your diet further is something that you should consider carefully. Our gastroenterologist can discuss the benefits and risks of this process with you. You may consider using medications earlier than this if your symptoms are severe.
It can take time to see the effects of an elimination diet. It might be months before you see the benefits of this process and some people are unable to identify trigger foods.
Medications
Proton pump inhibitors
We may recommend proton pump inhibitors (PPIs), such as Omeprazole, to reduce inflammation and the number of eosinophils. However, PPIs are not effective in all patients with EoE. Our doctor will explain this further during your consultation.
We may recommend PPIs alongside dietary changes. People with GORD (gastro-oesophageal reflux disease) and EoE may take PPIs to improve heartburn symptoms.
Topical steroids
Another option is topical steroids, such as swallowed budesonide in the form of an inhaler, liquid, or tablet. Budesonide is a weak corticosteroid. The first licenced drug to treat EoE – Jorveza – contains budesonide.
Topical steroids are effective at controlling inflammation and may prevent oesophageal narrowing. You may rarely experience a thrush infection in your oesophagus as a side effect of this treatment. Other side effects, however, are rare.
Endoscopic dilatation
We might use endoscopic dilatation to widen (dilate) your food pipe if you experience oesophageal narrowing. We widen your food pipe using a dilating device attached to an endoscope (thin, flexible tube). This procedure allows you to swallow easier and might improve your quality of life. You may need follow-up procedures, as it does not treat the underlying EoE.
You can learn more about this process by reading the UK guidelines on oesophageal dilatation in clinical practice. Our Consultant Gastroenterologist, Dr Sarmed Sami, is the lead author of these guidelines.
Book an appointment
If you are experiencing unpleasant symptoms due to EoE, you may benefit from EoE treatment. While there is no cure for EoE, we can help you manage your symptoms and improve your quality of life.
Our gastroenterologists will thoroughly assess your condition before recommending a treatment plan tailored to you. We will discuss all the treatment steps, benefits and risks with you before deciding on our approach. Feel free to ask any questions you may have.
Book an appointment today to start your treatment process, and prioritise your digestive health.
