Eosinophilic esophagitis (EoE) is a chronic inflammatory condition that affects the esophagus -the muscular tube that allows food to pass from the throat to the stomach- causing discomfort. Various factors contribute to developing the condition or triggering flare-ups, including certain food items. Understanding these trigger factors helps patients explore alternatives that are healthy to eat while managing the condition. Keep reading to learn more about foods that worsen EoE symptoms and how to avoid them.

Chocolate

Unfortunately, chocolate can be a trigger for EoE. Studies suggest foods that carry a higher probability of causing heartburn or acid reflux can worsen eosinophilic esophagitis in patients. Chocolate is one such food that is counter-indicated for patients with heartburn. To avoid complications, satisfy your sweet tooth with carob-based treats or enjoy desserts with alternative ingredients.

Nuts

Peanuts, almonds, walnuts, and many other nuts can result in an allergic response. Intake of these nuts can trigger severe EoE symptoms. Allergic reaction in the body leads to increased inflammatory levels and swelling. Replace nuts and peanuts with seeds, such as sunflower or pumpkin seeds, or explore nut-free alternatives. 

Seafood

Seafood is often considered one of the healthiest sources of protein and omega-3 fatty acids. However, shellfish and fish are also among the foods people can be allergic to. Intake of seafood can trigger eosinophilic esophagitis symptoms in some individuals. It can increase inflammation in the esophagus and might even trigger acid reflux in some patients. To improve symptom management and the severity of the condition, avoiding these foods from the meal plan is best. Instead, one can opt for other protein sources like chicken, turkey, or legumes.

Soy

Soy is a common source of food allergy in individuals. Its regular use might even lead to people developing sensitivity or experiencing digestional discomfort. Excessive intake of soy sauce, soy milk, and tofu can lead to complications as all of these products contain a type of protein that elicits an increased immune response in susceptible individuals. It can cause inflammation in the body. Soy is also a common product in various processed foods which may exacerbate EoE symptoms. One can seek anti-inflammatory alternatives like almond milk, coconut aminos, or other non-soy options.

Milk

Milk and dairy-based products, like yogurt and cheese, can easily trigger eosinophilic esophagitis symptoms. It is because of the presence of whey protein, casein, lactose, and other ingredients. These proteins can trigger an immune response, increasing inflammatory reaction and esophageal discomfort. Furthermore, dairy products are high in fat and can worsen symptoms like heartburn. Therefore, it is advisable to switch to dairy-free alternatives like coconut milk-based products, almond milk, and other lactose-free options. 

Wheat

Wheat is one of the most common sources of gluten. It is a widely used grain, along with others like rye and barley. Pasta, bread, and various baked food items contain wheat in them. Gluten is a type of protein that can give rise to immune-mediated reactions, causing esophageal inflammation and discomfort. To avoid this, use gluten-free grains to power your meals. One can switch to quinoa, rice, pasta, and gluten-free bread. Gluten can trigger an immune response in people with gluten sensitivity, celiac disease, and EoE. Skipping foods containing wheat has been shown to reduce flare-ups in patients and allow for better symptom management. 

Eggs

Eggs are another food item that causes an allergic response in EoE patients. The protein albumin found in egg whites is often responsible for triggering allergic reactions. Including eggs in the daily meal plan can increase the frequency and severity of symptoms. Replace eggs in recipes with substitutes like mashed banana, applesauce, or commercially available egg replacers. 

Spicy foods

Spicy foods, including peppers, hot sauces, and chili powder, can irritate the esophagus and intensify EoE symptoms.

Artificial additives

Certain artificial additives, such as food colorings, preservatives like sulfites, and flavor enhancers like monosodium glutamate (MSG), can trigger EoE symptoms. Read food labels carefully and opt for fresh, minimally processed foods to avoid potential triggers.

Healthy foods to eat 

While the above foods need to be avoided, there is also a similar list of foods that helps patients better navigate their EoE symptoms. These include-

• Banana-  Bananas are a rich source of fiber and low acid content. Since patients with EoE often struggle with acid reflux, the potassium found in bananas helps alleviate their symptoms. The fruit helps neutralize the acidity in the patient’s stomach. One can add it to the breakfast bowls or smoothies or have it as a snack option. 
• Turmeric-  Turmeric is well renowned for its anti-inflammatory properties. Curcumin, an active ingredient in turmeric, is found helpful in reducing the severity of inflammation in the stomach and the esophagus.
• Leafy green vegetables-  Green leafy vegetables carry high fiber content and are rich in essential nutrients. Vegetables like kale, collards, and spinach are also rich sources of antioxidants. The high nutrient value of these vegetables can help reduce inflammation levels and simultaneously help lower the severity of EoE symptoms. 

Eosinophilic esophagitis is a severe health condition that, if left untreated, can lead to the narrowing of the esophagus. Furthermore, it can lead to permanent damage and scars that make it hard for a patient to eat. Living with this chronic disorder can also affect an individual’s mental well-being. To manage the symptoms effectively, one should consult a nutritional expert who will suggest remedies like an elimination meal plan to determine which food items are the trigger factors. Health experts often recommend a six-food elimination meal plan, which involves excluding foods like milk, eggs, wheat, nuts, soy, and fish. However, after recovering from the symptoms, one can gradually reintroduce these foods to the daily meal plan.