Thank you for this unusually clear video of diet option journeys one can do to discover what the trigger(s) are for EOE. So that you can eventually go back to eating a wide variety of foods while avoiding your particular EOE triggers. Additionally it is so refreshing to hear from you as a GI, working with this disease through diet rather than throw a lifetime of pharma at it. When I say pharma I include meaning the known possible/probable long-term side effects.
Thanks for this, Mark! When I was first diagnosed, I tried the six food elimination diet and whoa...I lost entirely too much weight, had no energy, and ended up with low blood sugar at one point. Hearing you support the one food elimination is great. Unfortunately, my symptoms are back so it's DUECES DAIRY! Praying for more advancements with this annoying disease.
My son just got diagnosed! He’s 20, his esophagus was 10 is dilated to 15 and one more to 18 maybe one more after that to 20! What I felt so sad is the GI doc told my son he won’t succeed in keeping eliminations method bc he’s 20 and he had no choice but do the dupixent which he doesn’t want to do. Getting rid of dairy so far the esophagus looks improved just in 3 weeks! I’m so mad at the GI! He is good but closed minded and he told him he’s gonna fail keeping up the diet!
Sounds like your son is doing well which I’m glad to hear. If diet works and people appreciate the results they will often stick to it. It can be hard to identify a food trigger so I’m glad he has. I’m inclined to support either option (food or meds) as it’s the patient actually doing it, not me. Admittedly I have some preference for the elimination diet as it’s undoubtedly fewer side effects compared to meds. Congratulations to your son. Thanks for watching.
@@MarkCooperMD thank you! Let’s see his has a dilation in 2 weeks to move it to 18mm! He said he feels good getting rid of dairy. I thank you! This condition is so weird and so scary! In looking back it was overwhelming as a parent bc we just didn’t think his esophagus would get this small, we thought it was college stress! I am actually so thankful to the GI doc and his expertise! I just didn’t like the way they looked at me when they see him and I wish they would just support him and if he fails it’s ok, at least he knows he tried! I am all about food is medicine always have been. It’s very hard for me being so healthy to understand how kids eat now! It is kinda gross!
This is really helpful and encouraging! So the 90% of people that removing only dairy were able to go into remission? Or only improvement of the symptoms?
it could be correlated to foods high in histamine, I have EOE as well and noticed symptoms with avocado wich is also high in histamine just like tomatoes and chocolate
The data has been very good and it’s done well for many patients with asthma. EoE is sort of like asthma of the esophagus and so dupixent (dupilimumab) should often be effective.
I think I have eoe. I had to eliminate eggs, chocolate, spicy foods, pasta sauce so far, some dairy like pizza. I developed this condition in my 30s I was heart broken. I can't eat the foods I use to eat. I'm not sure how long I had the condition because I was a heavy drinker and smoker.
We cant even do a food elimination diet because by son only eats like 5 foods and is allergic to 10. He ended up being diagnosed with failure to thrive because he lost so much weight. Thats how we ended up with eoe tests. :(
Question I have EOE and haven’t been able to find a doctor that knows. I’ve cut out a lot but if I have Dairy or Gluten every once in awhile and it just makes my stomach hurt and make me belch just a little bit is it ok? I just don’t want my EOE to get worse over time by doing this
There’s question whether meat is getting stuck because it is tough or provokes an immune response. There’s a condition termed FIRE that may be the reason for some of the food obstructions.
I have had 3 events of beef getting stuck & have had to have it removed. Diagnosed with EOE put on PPI’s, gradualist weaning off, doing fine & then bam another episode. My esophagus was at 9 mm & doc said it should be 18-20. I need to schedule a dilation soon. I am going to eliminate soy & dairy to start. BTW, these events always happen when I am not eating at home. I typically eat very healthy, organic food
@@MarkCooperMD, yes; I was diagnosed with EOE and confirmed by the four biopsies taken during the endoscopy I had done last month. I was just wondering what the 75/HPF means that is stated in the biopsy report.
75 eosinophils per high powered field. Imagine an archaeological site that has the dig sectioned out with string. A similar layout helps to sample eosinophils.
@@MarkCooperMD , I see; thank you. The GI physician has me on 40 mgs of pantoprazole taken approximately 30 minutes before breakfast daily, and a once per week injection of Dupixent. So far, both make me feel tired and even slightly dizzy. I’m undecided how I feel about this approach with all this medication, but I suppose the doctor knows what he’s doing.
Mark, just found your channel. Any thoughts on people using the carnivore diet for eoe? It seems to be touted as the holy Grail for many issues, especially autoimmune disorders here on TH-cam.
We are herbivores. By nature. See my video on meat allergy. The idea that we are magically not at risk for allergy to meat is absurd. Grant it Alpha gal is rare. Carnivore diet just gets search hits and clicks because it seems sensational (as much as a diet can be sensational). It’s easy to find people who “swear” it helped. Don’t react to anecdotes. Look for data.
Do you have any tips for how often EoE patients can reasonably consume their allergen/trigger once they identify it? I have been able to narrow down my trigger to dairy and am so anxious about reintroducing it (fear of damaging my body) but would like to enjoy dairy from time to time.
Because EoE is an immune mediated condition even a small amount can trigger inflammation which can then take some time to subside. So occasional indulgence can drive a low level of inflammation. This is a key distinction between an immune mediated condition like EoE and a food intolerance like lactose intolerance. We don’t really recommend reintroduction of a clear trigger. I doubt substantial harm comes of a spoonful of ice cream. But there are so many great dairy substitutes that you may do best to explore those and avoid the issue all together.
Thank you for this unusually clear video of diet option journeys one can do to discover what the trigger(s) are for EOE. So that you can eventually go back to eating a wide variety of foods while avoiding your particular EOE triggers. Additionally it is so refreshing to hear from you as a GI, working with this disease through diet rather than throw a lifetime of pharma at it. When I say pharma I include meaning the known possible/probable long-term side effects.
Thanks for this, Mark! When I was first diagnosed, I tried the six food elimination diet and whoa...I lost entirely too much weight, had no energy, and ended up with low blood sugar at one point. Hearing you support the one food elimination is great. Unfortunately, my symptoms are back so it's DUECES DAIRY! Praying for more advancements with this annoying disease.
Glad the information helped and I hope you find some relief of your symptoms.
My son just got diagnosed! He’s 20, his esophagus was 10 is dilated to 15 and one more to 18 maybe one more after that to 20! What I felt so sad is the GI doc told my son he won’t succeed in keeping eliminations method bc he’s 20 and he had no choice but do the dupixent which he doesn’t want to do. Getting rid of dairy so far the esophagus looks improved just in 3 weeks! I’m so mad at the GI! He is good but closed minded and he told him he’s gonna fail keeping up the diet!
Sounds like your son is doing well which I’m glad to hear. If diet works and people appreciate the results they will often stick to it. It can be hard to identify a food trigger so I’m glad he has. I’m inclined to support either option (food or meds) as it’s the patient actually doing it, not me. Admittedly I have some preference for the elimination diet as it’s undoubtedly fewer side effects compared to meds. Congratulations to your son. Thanks for watching.
@@MarkCooperMD thank you! Let’s see his has a dilation in 2 weeks to move it to 18mm! He said he feels good getting rid of dairy. I thank you! This condition is so weird and so scary! In looking back it was overwhelming as a parent bc we just didn’t think his esophagus would get this small, we thought it was college stress! I am actually so thankful to the GI doc and his expertise! I just didn’t like the way they looked at me when they see him and I wish they would just support him and if he fails it’s ok, at least he knows he tried! I am all about food is medicine always have been. It’s very hard for me being so healthy to understand how kids eat now! It is kinda gross!
@@mayasauhtaDUPIXENT was insane cost wise for me. Still fighting it.
Very helpful video Dr. Cooper. Thanks so much!
This is really helpful and encouraging! So the 90% of people that removing only dairy were able to go into remission? Or only improvement of the symptoms?
I have EOE, are there multiple types because the foods that seem to bother me are tomatoes, onions, chocolate, lemons, etc.
it could be correlated to foods high in histamine, I have EOE as well and noticed symptoms with avocado wich is also high in histamine just like tomatoes and chocolate
@@michellebellwald Interesting. Thank you for your insight.
Any thoughts on dupixent as a therapy for Eoe?
The data has been very good and it’s done well for many patients with asthma. EoE is sort of like asthma of the esophagus and so dupixent (dupilimumab) should often be effective.
Will my swallowing issues go away soon? I have been on a puréed diet for about four weeks now. Stopped eating dairy, soy, and a bunch of other stuff.
Did it get back
I think I have eoe. I had to eliminate eggs, chocolate, spicy foods, pasta sauce so far, some dairy like pizza. I developed this condition in my 30s I was heart broken. I can't eat the foods I use to eat. I'm not sure how long I had the condition because I was a heavy drinker and smoker.
This as much sounds like plain old reflux. Did you have biopsy showing predominant eosinophilia?
Any updates on your progress?
@@MarkCooperMDhow can I reduce reflux please?
We cant even do a food elimination diet because by son only eats like 5 foods and is allergic to 10. He ended up being diagnosed with failure to thrive because he lost so much weight. Thats how we ended up with eoe tests. :(
Thanks a lot for making videos on eoe
God bless you
Want to show you my report
Need your suggestion
Is it possible
Question I have EOE and haven’t been able to find a doctor that knows. I’ve cut out a lot but if I have Dairy or Gluten every once in awhile and it just makes my stomach hurt and make me belch just a little bit is it ok? I just don’t want my EOE to get worse over time by doing this
@Mark Cooper, MD
What about meat? I’m hearing that beef could be a trigger
There’s question whether meat is getting stuck because it is tough or provokes an immune response. There’s a condition termed FIRE that may be the reason for some of the food obstructions.
Everytime my dad eats steak this happens to him. Some times it passes not too after but some times it stays stuck for hours.
I have had 3 events of beef getting stuck & have had to have it removed. Diagnosed with EOE put on PPI’s, gradualist weaning off, doing fine & then bam another episode. My esophagus was at 9 mm & doc said it should be 18-20. I need to schedule a dilation soon. I am going to eliminate soy & dairy to start.
BTW, these events always happen when I am not eating at home. I typically eat very healthy, organic food
Is 8% normal?
What does it mean in a pathology report that reads up to 75/HPF eosinophils in the esophagus? Thank you.
That sounds like you have eosinophilic esophagitis - but it depends on symptoms and where in the world you live.
@@MarkCooperMD, yes; I was diagnosed with EOE and confirmed by the four biopsies taken during the endoscopy I had done last month. I was just wondering what the 75/HPF means that is stated in the biopsy report.
75 eosinophils per high powered field. Imagine an archaeological site that has the dig sectioned out with string. A similar layout helps to sample eosinophils.
@@MarkCooperMD , I see; thank you. The GI physician has me on 40 mgs of pantoprazole taken approximately 30 minutes before breakfast daily, and a once per week injection of Dupixent. So far, both make me feel tired and even slightly dizzy. I’m undecided how I feel about this approach with all this medication, but I suppose the doctor knows what he’s doing.
You’re awesome
Mark, just found your channel. Any thoughts on people using the carnivore diet for eoe? It seems to be touted as the holy Grail for many issues, especially autoimmune disorders here on TH-cam.
We are herbivores. By nature. See my video on meat allergy. The idea that we are magically not at risk for allergy to meat is absurd. Grant it Alpha gal is rare.
Carnivore diet just gets search hits and clicks because it seems sensational (as much as a diet can be sensational). It’s easy to find people who “swear” it helped.
Don’t react to anecdotes. Look for data.
Do you have any tips for how often EoE patients can reasonably consume their allergen/trigger once they identify it?
I have been able to narrow down my trigger to dairy and am so anxious about reintroducing it (fear of damaging my body) but would like to enjoy dairy from time to time.
Because EoE is an immune mediated condition even a small amount can trigger inflammation which can then take some time to subside. So occasional indulgence can drive a low level of inflammation. This is a key distinction between an immune mediated condition like EoE and a food intolerance like lactose intolerance. We don’t really recommend reintroduction of a clear trigger. I doubt substantial harm comes of a spoonful of ice cream. But there are so many great dairy substitutes that you may do best to explore those and avoid the issue all together.