advertisement



Q & A Library


Print this page | Sign up for free e-bulletins
 | Bookmark This Page

Q
Zeroing In On Trigger Foods?

Can you provide any helpful information on eosinophilic esophagitis? I was recently diagnosed. I'm pretty sure I have food allergies/sensitivities, but all my skin scratch tests come up negative. Are there any other ways to find atypical food allergies?

A
Answer (Published 11/25/2011)

Eosinophilic esophagitis (EoE) is a relatively new addition to the list of allergic disorders, although evidence from biopsies shows that the condition has been around but unrecognized for decades. More recently it has become a frequent diagnosis in some parts of the U.S. I discussed your question with Randy Horwitz, M.D., Ph.D., medical director of the Arizona Center for Integrative Medicine and an expert on allergy and immunology.

Related Weil Products
Dr. Weil on Healthy Aging for Healthy Eating - Dr. Weil on Healthy Aging for Nutrition - Want to change your diet? The Dr. Weil on Healthy Aging online guide is your anti-inflammatory diet headquarters. Start your free trial and get access to an exclusive version of Dr. Weil's Anti-Inflammatory Food Pyramid, hundreds of recipes, eating guides, and more.

Dr. Horwitz told me that EoE is caused by the overproduction of a growth factor that attracts white blood cells called eosinophils to the esophagus. Eosinophils are involved in the development of asthma, among other allergic conditions. When high numbers of eosinophils accumulate in the esophagus, they can cause inflammation that leads to food intolerances and such symptoms as nausea, vomiting, and throat and abdominal pain, primarily in children. In adults, Dr. Horwitz says that EoE can commonly lead to narrowing of the esophagus (strictures), and food getting stuck in the throat (impaction).

A number of medical centers are intensively studying EoE, including Cincinnati Children's Hospital, Children's Hospital of Philadelphia, University of Arizona, and others. Most research is being done in pediatric cases, which tend to be more acute and severe than those seen in adults.

Dr. Horwitz explained that although allergists hoped that food triggers of EoE could be easily detected by skin testing, this method has not proven to be very effective. It can identify only some triggers, and in only some people. In most cases, a combination of skin tests and other tests are needed.

Until we can reliably identify EoE triggers, Dr. Horwitz says that your best bet is an elimination diet to try to figure it out on your own. Start by eliminating entire classes of foods (dairy, wheat, tropical fruits), monitor your symptoms; then slowly add back foods and reassess your responses. Because EoE flare-ups may occur rapidly after eating a trigger food and because it can take several days to weeks to recover, Dr. Horwitz advises adding foods back very gradually.

The approach Dr. Horwitz suggests for EoE is the same one that he recommends for food sensitivities - food-triggered symptoms such as headaches, fatigue and gastrointestinal upsets where triggers are not readily detected with conventional testing. In these cases and in EoE, the substances that aggravate symptoms tend to be very specific for an individual and few general rules apply to all.

Andrew Weil, M.D.

Creative Commons License Some Rights Reserved Creative Commons Copyright Notice
A portion of the original material created by Weil Lifestyle, LLC on DrWeil.com (specifically, all question and answer-type articles in the Dr. Weil Q&A Library) is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.

The Weil Vitamin Advisor
Get your FREE personalized vitamin recommendation & supplement plan today!

Dr. Weil on Healthy Aging
Your Online Guide to the Anti-Inflammatory Diet. Start eating for your health - begin your free trial now.

Dr. Weil's Spontaneous Happiness
Achieve emotional well-being
in just eight weeks!
Start your 10-day free trial now!

Vitamin Library
Supplement your knowledge with Dr. Weil's essential vitamin facts. Learn why they are necessary and more.

Dr. Weil's Optimum Health Plan
Your 8-week plan to wellness.
Begin your journey today!
 

Dr. Weil's Head-to-Toe
Wellness Guide

Your guide to natural health.
Use the Wellness Guide today!

Dr. Weil's Anti-Inflammatory Diet Food Pyramid
Our interactive tool can help improve overall health through diet.

Condition Care Guide
Learn about health conditions from acne to vertigo, and Dr. Weil's view of the best treatment options for each.

Healthy Recipes
Discover a treasure trove of healthy, healing foods and creative, delicious ways to prepare them.

Q&A Library
Over 2,000 questions from you
and their corresponding answers
from Dr. Weil.

 
Copyright © 2014 Weil Lifestyle, LLC
Information on this web site is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional. You should not use the information on this web site for diagnosing or treating a health problem or disease, or prescribing any medication or other treatment.

Ad Choice
Advertising Notice

This Site and third parties who place advertisements on this Site may collect and use information about your visits to this Site and other websites in order to provide advertisements about goods and services of interest to you. If you would like to obtain more information about these advertising practices and to make choices about online behavioral advertising, please click here