Triggers of Eosinophilic Esophagitis (EOE)

[@MarkCooperMD]

If you have EoE what's your trigger and have you successfully controlled symptoms by addressing it?

[@JasonActualization]

Gluten.

[@WilhelmWasserrausch]

Dear Mr Cooper, MD, thanks for your information, gluten is my trigger but I have also problems to swallow even when I "only" feel stressed.

[@JasonActualization]

@@WilhelmWasserrausch Eliminate gluten and processed vegetable (seed) oils! Corn, canola, cottonseed, soybean, sunflower, safflower, rice bran and grapeseed.

[@WilhelmWasserrausch]

@@JasonActualization Thank you!!

[@asekuaz]

I have it. Eliminating wheat/gluten and dairy fixed it. I’d be willing to bet that most cases are one of those two triggers. Not sure which one is mine but one of them for sure is. Maybe both.

[@curumo014]

I can attest to the airborne pollen, living on Kauai. There are certain days in the year that are just terrible, March and June so far are awful.

[@tonygSDWR]

I have not been formally diagnosed with EOE, but your video describes my symptoms very well. I do not have much acid reflux, but red meat occasionally causes an impaction that I can clear, but is uncomfortable and requires vomiting. I will see my doctor to seek treatment, but I think I have something to go on from this video.

[@gchap8910]

Go to a Gi doctor

[@irisfay3598]

I was diagnosed a few years ago. I went dairy, gluten, egg and soy free. I know 100% egg is a trigger because I get an instant reaction. Soy tends to dry my throat out a lot. And gluten I’ve had many impactions with. But, I haven’t had a impaction with any other food. Apart of me wants to Lee everything cut out besides dairy. Because dairy is so crazy good for you. But I’ve heard dairy and gluten are the main allergens? Also I scoped clean being on this 4fed but my gi has urged me to add one of these food groups in at least due to malnourishment

[@livsquackers_1143]

But what do you eat? I just want to get better.

[@naz.718]

@@livsquackers_1143try not eating the 6 diet elimination and see where you are and than do one of the 6

[@tionnamorton8543]

I only have flare up in spring. It makes me so sick I can’t eat anything. Doctors kept diagnosing with Gerd but I never had acid problems only nausea, vomiting and throat swelling. Around summer, fall and winter no flare ups and I can eat what ever I want without a flare up. I worked with allergist and gastro doctor. Did allergy test and pollen and dust caused a skin reaction.

[@vyasanh2010]

What to eat then??😐

[@LiamGutierrez]

Quinoa, Beans, Lentils, Rice and products made of these.

[@imstillw8ing]

Grass. You eat grass now.

[@LiamGutierrez]

​@@imstillw8ingyou eat grass. Not me Through the cow. Mooo

[@TSK24692]

He just rambles.

[@naz.718]

@@LiamGutierreznot beans or lentils they tell that’s an allergy

[@LacyBelt-tc4ye]

Thank you for all of your hard work Dr Ikpoko on KZbin, many of us in the HSV community are very appreciative of you and your team’s work.

[@user-jg8rg3du3z]

Many thanks for the information! If PPIs are effective for me, does this mean my trigger is GERD? Can I still do an elimination diet and find food triggers?

[@terryhook5518]

I had a infection a cis in my throat but it was to low for them to go in in pop it with a needle so I was in hospital for a week to it went down I couldn’t breathe now I have a lot of mucus stuck in my throat in it feels like a lump in it do u know what it is

[@naz.718]

He said nothing on this video that correlates to the title of the video. What triggers it??

[@TheGhamsh0s]

Hi dr , I am glad I found dr talks about this condition, my son( 13 years old ) was feeling for about 2 years that the food stock in his lower esophagus, we took him to GI dr and he made endoscopy and took samples result shown 17 lower and 15 above , also shown Forrow and yellow area , dr diagnosed him with eoe and acid reflux, we did elemenation diet without success he also is using budsionde also did not help , we recently added ppi , when he was infant he had sever acid reflux and we used Zantac and ppi liquid that time for almost 2 years , after that he was good until this problem happend to him , I think acid reflux is the main reason he got Eoe , but when ever we ask him about acid reflux symptoms like heart burn he is saying he can feel any symptoms, my question dr , is it possible that acid reflux is the cause ? Why he don’t have acid reflux symptoms? What is causing the acid reflux when he was infant? His dr told us that esophagus muscle is fine , he is using 20 mg ppi , is it enough, also many drs in KZbin saying that there many side effects of ppi , like malabsorption, SIBO , kidney diseases , etc , is it safe for long time , thanks

[@MarkCooperMD]

While there are risks with long term use PPI they are relatively small and against the certain problem he is having it’s reasonable to decide the benefit exceeds the risks. It is possible to have esophagitis without distinct heartburn symptoms, but usually there will be some other symptoms-it sounds like trouble swallowing in his case. Acid reflux can increase eosinophil counts. The counts he has are not super high so perhaps acid reflux is a big contributor. I hope he feels better.

[@noogieboog]

I drank some prebiotic yogurt. So far, so good.

[@benjamesv]

Can leaky gut / intestinal permeability be a possible cause / contributor to EOE?

[@MarkCooperMD]

More likely factors of permeability play a role directly in the esophagus. That may be why PPI can improve many cases of eoe - with healing of the esophagus lining there’s less exposure of food antigen to deeper areas of the esophagus.

[@benjamesv]

@@MarkCooperMD Makes sense, but could intestinal permeability cause your body to have a food allergy in the first place? Because people with GERD would also have a leaky oesophagus, but don't have any food allergies like the EOE people do. Also, is EOE classed as an "autoimmune disorder"? Thanks

[@rockievanescent6025]

Can a 4 year old have EOS. He got RSV a few years ago, came with eczema and constant dry cough and when he cries he gags up mucus like he has acid reflux. Did numerous tests, at times he is congested with runny eyes and nose

[@MarkCooperMD]

While uncommon a 4 yo can have EOE. RSV does seem to cause some reactivity issues though I don’t think of it being specifically eosinophils. Environmental allergens, particularly any smoke (tobacco, marijuana, vaping) or pets, would be another consideration.

[@NikkiBradley-e1t]

My 3 year old was just diagnosed after an endoscopy. He is starting treatment today.

[@Kay091-ew3qi]

Can this cause mucus sitting in my throat?

[@skipjones3415]

Stress triggers it too

[@Jaydenreco]

I agree

[@wavyybased1820]

Do you feel a ppi is better than surgery? Assuming the medication is working for pt.

[@MarkCooperMD]

A PPI that works is great. Sometimes a dilation is needed to disrupt scar tissue caused by EoE. Medicines don’t improve scar. So there are times a procedure is needed.

[@jarekotrebski4193]

Can I have this and bronchus area as well affected?

[@MarkCooperMD]

Yes. Asthma and EoE are in a way the same disease in different organs.

[@leannemayor5755]

I have this and gastro paresis all thought to be caused by long term lupus my pancreas is about half the size it should be and the lower portion that’s left has cyst on it. It’s a world of pain and I barely eat these days. I have to take ondenzatron before I can even take my medication. My gastro just told me that even with surgery I’d maybe get three months of peace. It’s and I’m not sure what else I can eliminate food wise . The acid in my mouth never goes away so even if I want to eat and force myself to nothing taste right. Thanks for your videos xo

[@MarkCooperMD]

Sorry you’re going through this. SLE is a very difficult disease to endure.

[@bobbyadkins6983]

My eosinophils level was a high 7.9. I had recently tried going off my generic for Prilosec and I started having trouble eating again. I guess this could be the cause for my high level?

[@olgatuzkov4882]

What doctor do you see I you know those numbers? I think I have it this problem. I believe I have this problem. What test should I have?

[@bobbyadkins6983]

@@olgatuzkov4882 Just regular blood work is what I have done every six months.

[@tmsact]

Serious question, does the pain ever go away. Will I ever go into “remission”? I was just recently diagnosed.

[@MarkCooperMD]

Yes you hopefully will go into remission and may feel considerably better in a month. Good luck.

[@tmsact]

@@MarkCooperMD thank you! 🙏 your video helped. I truly appreciate you taking the time to post it. I feel alone dealing with all of this. I have worked in healthcare for 18 years and have never heard of this before. It’s been a nightmare. Glad to hear there is light at the end of the tunnel.

[@MarkCooperMD]

@@tmsact thanks for taking the time to share that as it is the reason to do this!

[@JasonActualization]

@@tmsact I was diagnosed at age 15, and now, 13 years later, as a pharmacist, and someone who overcame EoE autoimmunity without any medication, and I think I can help you immensely. I would urge you to explore the carnivore diet, more specifically, what I'd recommend, is carnivore plus carbohydrates such as white rice or sweet potatoes. Thick meats like steak reveal the underlying inflammation, but they don't actually cause it. The cure hides where the cause resides, and for me it was gluten that was making me highly inflamed. I will upload a video soon to my channel, a complete guide, for sufferers of EoE. This condition has taken so much from me in the front end (i.e., shyness, social anxiety, light-level autism, etc.) but offered so much more on the backend, on the other side of that struggle.

[@nolives]

​​@@JasonActualization saw this comment of yours on another eoe video and ill repeat my response here: meat, especially red meat, and breads, especially wheat, are the most likely foods to get stuck in the throat with e.o.e. I would suggest nobody take this advice of yours especially before talking to their gastro doctors.

[@matt_iyy]

Hi, I'm looking for an opinion from you. A year ago I was diagnosed with EOE, with 25 eosinophils. After steroid therapy I had a complete remission, but given the complications of candidiasis that it caused me, I interrupted the treatment and tried therapy with proton pump inhibitors, but my Eosinophils at the end of the therapy were 30. I have always been left between 20 and 30. I decided to do the 6 food elimination diet, but after 8 weeks my eosinophils became 100, and 50 also in another part of my esophagus. Could anyone give me their opinion on how this was possible. The only explanation I can give myself is that during the diet I was eating too much of a food to which I am allergic. I await your opinion too.

[@MarkCooperMD]

I believe you posted on one of the other videos and hopefully found my comments. Thanks for watching.

[@matt_iyy]

@@MarkCooperMD Thanks but I don't see the reply comment. I'm reading a lot of comments in the video and also the one you pinned. It is possible to notice immediately during ingestion if a food bothers me in the esophagus, because many times by eating for example kiwi, milk, etc. I notice esophageal irritation and subsequent sensation of swelling which creates difficulty in swallowing. Is it possible to notice symptoms when ingesting food?

[@MarkCooperMD]

Yes it is possible to have symptoms with swallowing food. Kiwi is an unusual trigger but fits a wider pattern of foods that contain proteins similar to the latex tree - this includes kiwi as well as avocado and others.

[@matt_iyy]

@@MarkCooperMDI the IGE test for all foods, but it’s positive Just for aeroallergens and for melon. I read a lot about it, and I saw a lot of articles that explain IgG could they be part of eosinophilic inflammation? So I wonder, could it be useful to do tests on IgG foods too? what do you think?

[@MarkCooperMD]

Was ragweed particularly strong reaction.

[@DragonDM369]

So i just got diagnosed with esophagitis grade d and eoe.......if i cure my esophagitis grade d will it help my eoe?

[@MarkCooperMD]

Very likely it will. It also may be that there’s a mixed inflammation with a heavy amount of eosinophils. Once that calms down things may look much better. Typically we recommend a second look after a few months on PPI twice daily. Make sure both morning and evening doses are before meals to be maximally effective.

[@DragonDM369]

@@MarkCooperMD ok :/ i have an endoscopy in about 2 weeks.....im on Omeprazole until then

[@MarkCooperMD]

2 weeks after the first one? Or you got diagnosed awhile ago.

[@DragonDM369]

@@MarkCooperMD no i was diagnosed few months ago this will be my second endoscopy.....the first one i was too inflamed to get a biopsy

[@MarkCooperMD]

Ok. Without a biopsy they can’t really say you have EoE.

[@ijohnas3825]

Is leukocytes the same as eosinophils

[@MarkCooperMD]

No. They are not the same as leukocytes

[@HuttCornelia-m1v]

Wilson Eric Martin Sharon Lee Brian

[@MarkCooperMD]

Are you debating what to name your kid? Eric is my vote. You need more girl names.

[@ItsTerrahCard]

I have EoE and I’m allergic to milk and dustmites. It sucks.

[@gchap8910]

I have it too, and I'm elergic to milk, but my gi put me on omeprazole, and it has helped