As you live with and treat your eosinophilic esophagitis (EoE), you’ll see a variety of health care specialists who can help you manage your condition. Each has a different focus.
Primary Care Physician (PCP)
Your EoE journey will most likely begin at your primary care physician’s (PCP’s) office. They’ll do a physical exam and assess your symptoms.
Because most of the symptoms of EoE – such as a hard time swallowing, food getting stuck when you swallow, and the backflow of food – are digestion-centered, your PCP may refer you to a digestion specialist.
After your EoE diagnosis, your PCP will stay in contact with the other members of your EoE team. This way, your EoE is taken into account when decisions about your general wellness or other medical issues are made.
Gastroenterologist (GI Doctor)
A gastroenterologist is likely the first specialist you’ll see for your EoE. These doctors specialize in digestive disorders. Your PCP will only be able to talk you through your symptoms, which isn’t enough to make a diagnosis of EoE. For that, you’ll need certain tests that a GI specialist can provide.
Your gastroenterologist will give you a test called an upper GI endoscopy, or EGD. Sometimes, doctors call this a “scope.” The test involves a small camera on a long flexible tube that the doctor puts down your throat and into your esophagus. They take photos and small tissue samples (biopsies) of your esophagus, and sometimes your stomach and small intestine as well.
A pathologist (a scientist who studies diseases) will look at your biopsy under a microscope. If they see inflammation or eosinophils (white blood cells), your doctor can diagnose you with EoE.
A gastroenterologist can monitor your progress with the disease as you try treatment or other therapies. You may have multiple endoscopies with your GI doctor as part of your management.
Along with medications and diet therapy, one of the treatment options for EoE is a procedure called esophageal dilation. If your esophagus has a stricture (narrowing), a GI doctor can perform this procedure, which involves stretching out the walls of your esophagus to enlarge it.
Allergist/Immunologist
Although EoE symptoms affect the esophagus, which a GI doctor focuses on, the disease itself is a chronic allergic/immune condition. Allergies play a big role in EoE. Around 70% of people with EoE have symptoms of one or more allergic disorders, such as asthma, allergic rhinitis, atopic dermatitis (eczema), or food allergies. You may already be under the care of an allergist for one or more of these issues if you have EoE.
An allergist should be involved in your EoE care because oftentimes, you need a food allergy assessment to see what foods may be helping cause your symptoms. Your allergist can do a prick test to see which foods cause a reaction.
You may also need diet therapy, which your allergist can help design and guide you through.
Typically, this involves removing all major allergens (wheat, milk, egg, nuts, soy, fish, and shellfish) from your diet and adding them back in, one at a time, to see how your system reacts. Your allergist will work closely with your gastroenterologist through this monitoring process.
Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN)
If food is triggering your EoE and diet therapy is necessary, a registered dietitian (RD) or registered dietitian nutritionist (RDN) – a more recent version of the same specialty – can be a crucial piece of your treatment plan. They specialize in nutrition and help people develop eating plans to meet certain health needs.
Elimination diets require major changes in your eating habits. This may cause you to feel overwhelmed. You may also have to avoid some foods because they’re hard to swallow as your esophagus heals during treatment. An RD/RDN can guide you through these changes and be sure you’re still getting the nutrition you need.
Psychologist or Counselor
Living with a chronic digestive disorder like EoE affects your daily life. EoE has an impact on your stress levels and mood. A psychologist who focuses on GI issues (called a GI psychologist) is a specialist who can guide you through the emotional side of digestive issues.
GI psychologists focus on the brain-gut connection to help reduce your symptoms and enhance your quality of life. They can help you understand and strengthen the relationship between your digestive health and emotional health.
Treatment from a GI psychologist isn’t a replacement for medical treatment. But they can work closely with your gastroenterologist to support your whole well-being.
If a GI psychologist isn’t available to you, a trained counselor or therapist can help you process the emotional side of your diagnosis and any stress that comes along with it. They may use talk therapy or tools such as cognitive behavioral therapy, which is a process that helps you control negative thoughts and behaviors.
Social Worker
As with any chronic disease, EoE comes with many medical appointments, logistics, and financial complications. A social worker helps you advocate for yourself as you go through treatment. They can also link you to community resources that can support your wellness.
Like a trained counselor or psychologist, social workers can also help you navigate the feelings and emotions that come with managing your condition. They can also point you in the direction of a mental health professional who can provide you more specific care.
Show Sources
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SOURCES:
Mayo Clinic: “Eosinophilic Esophagitis,” “Use of dietary strategies in treating eosinophilic esophagitis.”
American Academy of Allergy, Asthma & Immunology: “Eosinophilic Esophagitis.”
American College of Allergy, Asthma & Immunology: “How can an allergist help treat EoE?”
Kids with Food Allergies: “Your Guide to Managing Eosinophilic Esophagitis (EoE).”
Cleveland Clinic: “Dietitian.”
UCLA Health: “GI Psychology.”
American Psychological Association: “What is Cognitive Behavioral Therapy?”
Nationwide Children’s: “Eosinophilic Esophagitis (EoE) Program.”
