Thursday, July 8, 2010

Sharing My Family’s Experience With EE – Food Allergies

This is part of a series of blog posts sharing my family’s experience with eosinophilic esophagitis (EE) in response to reader questions. Check out prior installments in the series here, and always consult your physician.

At this point in the story we knew for sure that my son suffered from EE, but we didn’t yet know what was causing the problem. The connection between EE and food allergies was just starting to emerge in the medical community, so we set out to look for food allergies.

At the allergist’s office my son was tested for food allergies using a skin prick test. He tested negative for all foods(including the top eight), but he did show a very mild reaction to milk. The allergist essentially told us he didn’t have food allergies at all, but I was still certain that he did.

Next, we did a RAST test – a blood test that checks for IgE responses to food proteins. This was our real breakthrough, where we discovered that my son was allergic to wheat, milk (both with strong reactions), soy protein, egg whites, and peanuts (the last three with medium reactions). Note that like most food allergies, it is the proteins in the food that he is allergic to.

In our case the skin prick tests were not helpful, and it was only through a blood test that we were able to diagnose the allergies. Once we eliminated the foods he was allergic to he was fine.

Readers have asked me whether my son uses Flovent for treatment.

A bit of explanation – Flovent is typically prescribed for asthma. It’s a steroid that is usually inhaled into the lungs to ward off asthma attacks. Early on, researchers found that Flovent could be used for EE patients as well. Instead of inhaling the mist, the patient swallows it so that it goes down the esophagus.

When we first suspected my son had EE, his doctor prescribed Flovent. At that point in time his esophagus was severely inflamed. The Flovent was being used to try to heal his esophagus as well as to try to determine whether it really was EE. Also at that point we hadn’t yet determined what foods he was allergic to.

I get a little bit nervous when I hear of inhalers being used for long-term treatment. In my opinion, eating foods that you are allergic to and using an inhaler to minimize the distress is a bit like intentionally running through a field of poison ivy and then pouring calamine lotion over the resulting rash.

I think the inhalers are great for healing an inflamed esophagus or for when there is an unexpected flare-up, but the only real treatment is to avoid the foods you are allergic to.

This concludes my series on EE. If you have a question on this topic you would like me to address please send me an e-mail or leave a comment here. If you want to hear from physicians on EE, check out the transcript of the APFED twitter party from National Eosinophil Awareness Week.


Carina said...

My son and I both have EE. We each used Flovent upon diagnosis (his was diagnosed before mine) for a short period of time. Once the inflammation was under control, we haven't used it often. I think steroids have an place in treatment for EE, but I agree that elimination is the best long term plan.

I'm enjoying reading your blogs on EE, by the way.

Colette said...

Carina, so glad you found me! You must have been suffering a long time before your diagnosis. Thanks for sharing!

Beth said...

Thanks for the great blog! My son also has EE, but he is allergic to basically every grain and numerous other items based on skin and patch testing. Even when we removed the supposed allergens from his diet, his esophagus remained inflamed, so it seems he is stuck on the Flovent. He's never had RAST testing. We are seeing a new allergist in June and maybe she will want to include that. It was my understanding that there is no type of testing that will truly define what is causing the EE. We're off to another endoscopy on Tuesday...

Colette said...

Beth, I believe you are correct. If you can't eliminate the problem with avoiding food allergens, there may be other causes for your son's EE. Hopefully the research will advance soon so we can learn more. It's all so new.

Unknown said...

That's very interesting that the skin test showed different results to the rest test. I haven't had the skin test but have had numerous rast tests along with another blood allergy test. Is the east test still the gold standard??? According to mayo clinic EE can be triggered by airborne allergens.