TLDR; then skip to the last paragraph.
My cousin has allergies. I also have allergies, so he was sharing his situation with me, and I’m trying to get a better understanding from people who have experience with Eosinophilic Esophagitis (EoE).
This is the history. For about 8 years or so he said he was having problems with constant throat-clearing feeling like he had a lot of phlegm there. This was also making his voice raspy sometimes and it started to get worse. This was a problem for him, because he does professional voice-overs.
So after dealing with this, he went to see a gastroenterologist 5 years ago. The doctor said, he needed a EDG to scope him and take a look, because there might be an issue with the esophagus.
After the EDG, the doctor said everything was fine, except the biopsy said he had EoE and prescribed him 40 MG of Omeprazole and Flovent inhaler to be swallowed twice a day. The doctor told him that the EoE was being caused by a food allergy. So he went to his allergist and got food tested. Nothing new showed up for food allergies that he didn’t already know about and had always been easily avoiding. The allergist and the gastroenterologist told him that a skin test might not catch all the foods that is causing an allergic reaction for the EoE. So the allergist put him on an elimination diet, which consisted of six foods. He told me he did this very carefully, and even ended up repeating it to see if he could produce the same results as the first time, and it wasn’t reproducible.
He continued to take the Omeprazole and the Flovent. Then after a few months things started to get better. He stopped the Flovent and continued with the Omeprazole. He told the gastroenterologist he didn’t notice any difference with or without the Flovent after several montsh so he stopped taking it.
He said after a year or so, the problem with throat-clearing and his raspy-voice pretty much went away. He said at the worst, of a scale of 1-10, it was a 10, and then and even now it was a 2. He felt that was good enough, and the gastroenterologist said he could reduce the Omeprazole to 20 MG.
So for the past several years he has been on 20 MG of Omeprazole and no problems. He sees the gastroenterologist on another matter who says, “It has been 5 years since you’ve had you last EDG, let’s get you scheduled”. He told the gastroenterologist that he wasn’t having any symptoms, but was told they need to do this to see how the EoE is and to make sure there is no narrowing and constriction which can lead to problems swallowing. He told the doctor, he never had any problems with swallowing, but doing this was to make sure he didn’t have any. He asked if there was a problem with swallowing, how would it be treated and the doctor said with swallowing Flovent. He said he talked with his allergist about this, and said trust your doctor and go ahead with the EDG.
So last month, he had the EDG. He called to tell me the results today after his office visit with the gastroenterologist. He has about the same number of EoE he had 5 years ago without being treated, even though he no longer has any symptoms for throat-clearing and the raspy-voice. However, the gastroenterologist prescribed to increase the Omeprazole from 20 MG to 40 MG, and to start swallowing Flovent twice a day, and to start The Six Food Elimination Diet for Eosinophilic Esophagitis:
He mentioned to the gastroenterologist that he tried a food elimination before, but these were done to see if they simply changed the symptoms. He said the doctor repeated that you need to find out what the food allergy that is causing the EoE. The doctor also said to pay close attention to what you eat when adding foods back.
My cousin is telling me all this and I asked him, what exactly are you being treated for at this point since you have no symptoms. His take away is that he is doing this to avoid having narrowing, and constriction which can cause problems with swallowing.
I’m posting about this, because this doesn’t make a lot of sense to me. I have allergies and my allergist treats the symptoms. I can understand the concept of prevention, but I don’t know how severe or sudden a problem with swallowing comes on for someone who has EoE.
So if you have EoE and trouble swallowing, please share your story about it. Was this something that hapended to you gradually? If you think you might be a risk of this, is it something you can monitor and then start swallowing Flovent again or some other rescue type of treatment? I’d appreciate your help in understanding this, because to me it seems like this doctor is prescribing patients aspirins because they might get a headache someday.