Who Should Be on Your Eosinophilic Esophagitis (EoE) Treatment Team?

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By Staff
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3. Allergist or Immunologist

Tests for food or environmental allergens, performed by an allergist, may play a role in EoE management, especially if you’ve ever had any food intolerances or allergic reactions, says Schnoll-Sussman.

“If dietary elimination therapy is needed, an allergist may recommend which foods are going to be avoided,” she says. “The allergist may manage other conditions, such as seasonal allergies, as well.”

Between 50 and 80 percent of people with EoE have allergic disorders like asthma, atopic dermatitis, and food allergies. In some cases, EoE may not manifest with allergies at first, but they can develop over time. That’s why regular monitoring by an allergist or immunologist is important, Schnoll-Sussman says.

4. Registered Dietitian

For some with EoE, dietary changes are necessary to relieve symptoms, says Schnoll-Sussman. For instance, your health team may put you on an elemental diet, which involves temporarily avoiding all foods and instead drinking a formula containing amino acids, short-chain triglycerides, and short-chain maltodextrins combined with vitamins, minerals, and electrolytes. This is designed to reduce inflammation and is utilized until symptoms begin to improve.

Those with EoE who have suspected food allergies or intolerances may also be guided through an elimination diet to identify trigger foods that worsen their symptoms. An elimination diet involves temporarily avoiding certain foods and then reintroducing them in a certain order to see which ones may be triggering your symptoms.
“Because of potential changes or eliminating certain foods, dietitians can be essential as part of an EoE health team,” Schnoll-Sussman says. “They ensure proper nutritional requirements are being met as well.” That’s because people with EoE are more prone to deficiencies of certain nutrients, such as calcium and vitamin D, especially if they have to avoid certain foods.

“[Dietitians] also provide education in reading labels and lifestyle changes,” says Schnoll-Sussman. For example, they can help you learn to identify packaged foods that may contain your triggers, as well as ways to avoid accidental cross-contamination (when your allergens may be accidentally or unknowingly introduced into other foods, like at a restaurant or buffet).

5. Mental Health Professional

At times, a mental health professional such as a licensed therapist or social worker may be necessary to help manage anxiety, depression, or stress related to a chronic illness.

“It can be very hard to manage food-related diseases, because they can affect lifestyle choices on a daily basis,” says Dr. Schnoll-Sussman. “This can be especially difficult for young children and adolescents.” Research suggests that at any age, EoE can lead to mental distress, which can sometimes worsen EoE symptoms or make them more frequent.

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