Eosinophilic esophagitis (EoE) causes have five general kinds:
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EoE caused by allergens: This is not directly related to MCAS. Try allergen minimization, antihistimines, antiallergens, and allergy immunotherapy.
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EoE caused by throat reactions: This means irritants in the throat, such as spicy foods. This is not directly related to MCAS. Try trigger minimization i.e. don't eat/drink things that hurt your throat.
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EoE caused by ingestion-driven acid reflux: This means acid inflames or injures the esophageal tissue. This can be caused by many things, such as certain foods and drinks, fatty or spicy foods, etc. This is not directly related to MCAS. Try antacids, which reduce the amount of acid in your stomach.
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EoE caused by a structural failure of the esophagus: There is a ring of muscle fibers in the lower esophagus that prevents swallowed food from moving back up. When this ring of muscle does not close all the way, then stomach contents can leak back into the esophagus. Try proton-pump inhibitors, eating smaller meals, not lying down after a meal, lowering caffeine and alcohol, and losing weight.
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EoE caused by hyper-activation of gastrointestinal mast cells: When mast cells are hyperactive, they release too much histamine, which triggers too much stomach acid production (regardless of ingestion), which leads to acid reflux. This kind of EoE is caused by a mast cell disorder. Try mast cell stabilizers, including over-the-counter famotidine (brand name Pepcid) which is an H2 antihistamine and has mast cell stabilizer effects.