Eosinophilic esophagitis (EoE) is a chronic condition where the esophagus becomes inflamed due to an excessive number of white blood cells called eosinophils. This inflammation can lead to difficulty swallowing, chest pain, and food impaction. Many people with EoE are prescribed biologic therapy to help reduce inflammation, but certain foods can still worsen symptoms, even while on treatment. Understanding which foods may aggravate EoE is essential for managing symptoms and improving quality of life.
Dairy is one of the most common food triggers for people with EoE. Milk, cheese, and other dairy products can cause the immune system to react, worsening inflammation in the esophagus. Even though biologic therapy may help reduce inflammation, it might not be enough to completely counteract the effects of dairy on the digestive system. For many EoE patients, eliminating or reducing dairy intake can help prevent flare-ups.
Wheat, barley, and rye contain gluten, a protein that can irritate the esophagus in individuals with EoE. Even though biologic therapy works to reduce eosinophilic activity, gluten may still contribute to inflammation in the digestive tract. Gluten-free diets are often recommended for people with EoE, as they may help reduce symptoms and improve overall digestive health.
Processed foods, including fast food, packaged snacks, and frozen meals, often contain additives and preservatives that can irritate the esophagus. These foods may also be high in sugar, unhealthy fats, or artificial ingredients, all of which can worsen EoE symptoms. Opting for fresh, whole foods can reduce the risk of triggering an allergic or inflammatory reaction in the esophagus.
Citrus fruits like oranges, lemons, and grapefruits, as well as tomatoes, can increase acid reflux and irritate the esophagus. Even with biologic therapy, these acidic foods may still contribute to discomfort and inflammation in people with EoE. Avoiding highly acidic foods and drinks may help reduce the risk of flare-ups and manage symptoms more effectively.
Spicy foods, including hot peppers, chili, and certain seasonings, can irritate the esophagus lining and increase inflammation. These foods can cause discomfort and make swallowing more difficult for individuals with EoE, even if they are on biologic therapy. It’s often recommended to avoid or limit spicy foods to minimize symptoms.
Nuts and seeds, while healthy for most people, can be problematic for those with EoE. Their small, hard texture can irritate the esophagus, and they may trigger an allergic response in some individuals. Even on biologic therapy, it may be best to avoid these foods to prevent esophageal irritation and inflammation.
Red meat can be harder to digest and may increase the risk of acid reflux, making it a potential trigger for people with EoE. Though biologic therapy helps reduce inflammation, the high fat content in red meat may still cause discomfort and worsen symptoms for some individuals. Lean protein sources like poultry and fish may be better options.
Alcohol can irritate the digestive tract and increase acid reflux, which may worsen EoE symptoms. It may also interact with medications, including biologics, potentially reducing their effectiveness. Limiting alcohol intake can help manage symptoms and avoid complications.
While biologic therapy can significantly help control EoE symptoms, it’s important to recognize that certain foods may still aggravate the condition. Identifying and avoiding these triggers can play a key role in managing EoE and maintaining a healthier, more comfortable lifestyle. Working with a healthcare provider and a dietitian can help individuals make informed dietary choices tailored to their needs.
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