WHY YOU SHOULD READ THIS NOW
If you ever have trouble swallowing, or heartburn that doesn’t respond to standard medication, you may have Eosinophilic Esophagitis (EoE).
Unlike GERD, EoE won’t always improve with acid-suppressing medications like Nexium or Prilosec.
Left untreated, EoE can scar and narrow your esophagus, making it hard (or impossible) to swallow.
Diagnosis is often missed for years unless a doctor takes biopsies of the esophagus during endoscopy (simply looking isn’t enough).
Keep reading to see if that viral “Pink Drink” really lowers your stress hormone...
Today’s Opponent:
Eosinophilic Esophagitis (EoE)
EoE is a chronic allergic condition of your esophagus, often triggered by food sensitivities or environmental allergens (such as microplastics). It inflames your esophagus, making it stiff and leading to scarring.
Patients often get told they have “refractory GERD” because symptoms (heartburn, regurgitation, food getting stuck) can overlap, despite EoE and GERD being different disorders.
Why EoE Diagnoses Gets Missed
Your esophagus can look completely normal on endoscopy. That’s why biopsies are essential. They reveal clusters of eosinophils (allergy-related white blood cells) that don’t show up to the naked eye.
It gets trickier, too:
Recent research suggests microplastics exposure might contribute to EoE risk. A 2025 World Journal of Gastroenterology review highlighted how microplastics (MPs) can:
→ Damage your inner or “epithelial” lining, the very barrier meant to protect your esophagus
→ Trigger oxidative stress and inflammation
→ Alter your gut microbiome and reduce nutrient absorption (study)
While no study has yet proven a direct causal link between microplastics and EoE, the overlap is concerning. EoE is an immune-mediated condition, and microplastics are increasingly shown to prime inflammation and weaken barriers throughout your GI tract.
Add in evidence that poor water quality and microbiome disruption raise EoE risk, and a bigger picture emerges: this disease may not just be about food allergens…
It may also be about the environment we live in.
Who Gets It?
More common in men, often younger, though can develop in anyone
Frequently seen in people with asthma, eczema, or seasonal allergies
Classic Red Flags
→ Food getting stuck mid-chest (sometimes resulting in a “food impaction”, requiring an urgent ER visit)
→ Reflux symptoms not responding to PPIs
→ Difficulty swallowing bread, meat, or pills
Risks of Missing It
Chronic untreated EoE can scar and narrow the esophagus, sometimes requiring dilation procedures to reopen.
Treatment Options
Elimination diets (removing common triggers like dairy, wheat, soy)
PPI therapy (a subset of EoE patients do respond to standard PPIs, but this might not be the best long term choice)
Swallowed topical steroids (like fluticasone)
Biologics (dupilumab was FDA-approved for EOE in 2022)
“Just last month, I saw a patient who thought she had GERD for ten years. She’d been through every reflux medication with no relief. A biopsy finally revealed EoE, and within weeks on the right treatment, she could swallow comfortably again. If your reflux isn’t improving, push for an endoscopy with biopsies, even if your esophagus looks ‘normal’.”
“It’s remarkable how many times I’ve seen and endoscopically treated food impactions (food stuck in the esophagus), only to diagnose EoE as the underlying cause.
The key is awareness for both patients and doctors. GERD isn’t always GERD; if swallowing feels off, don’t just double your dose of Nexium... seek professional evaluation.”
What To Tell Your Doctor
“I’ve had reflux symptoms that aren’t improving with PPIs, and sometimes I feel like food gets stuck when I swallow. Could this be EoE, and should we consider biopsies even if my esophagus looks normal?”
TikTok Trend We’d Ban
The “Pink Drink” that Reduces Cortisol?!
You might have seen influencers mixing up a pastel “pink drink” made up of electrolytes, collagen, and sometimes beet juice. They’re claiming it lowers cortisol, your body’s main stress hormone.
I hate to burst the bubble here, but there’s no clinical data showing this concoction lowers cortisol. None. Cortisol is regulated by your adrenal glands and nervous system, not by a scoop of pink powder.
This claim is stressing me out.
That said, some ingredients (like electrolytes) can support hydration, and beet juice contains nitrates that can help improve blood flow.
And yes, collagen is a solid protein source, I take it myself. So while it’s not harmful for most people, the cortisol claim is mostly TikTok fiction. At least in terms of having clinical data behind it.
If you want to reduce cortisol in a way that’s actually proven? Sleep, exercise, stress management, and balanced nutrition. No shortcuts in a shaker bottle.
Verdict: BANNED.
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As gastroenterologists, we definitely have a lot to talk about when it comes to your gut health and well-being. But we can’t always get to everything (you know… like coffee enemas)! So reply directly to this email or DM us on TikTok below and maybe YOUR topic will be featured soon!
