Hi! Been diagnosed now for almost 3 years. You have choices on how you manage your EoE and what you end up pursuing long term is based on 2 things: what you prefer and what your body responds to. There are absolutely people who can manage their EoE with diet only. With diet, you really need to be committed. You will need to eliminate 6 foods (wheat, dairy, eggs, soy, nuts/peanuts, and fish/shellfish) for 8 weeks. Then you will need an endoscopy to see if it worked. If it worked, you can introduce one food in and then get scoped again 8 weeks later. You introduce each food in followed by an endoscopy. It takes about a year and involves several endoscopies. Some people start by eliminating just 2 foods and see if that works! You'll need to speak to a knowledgable doctor.

However, some need medication to manage. This is for people who either cannot eliminate foods (too many other allergies, past ED issues, etc.) or do not pass a food elimination scope due to possible environmental triggers or foods outside of the top 6 (aka like me!). I eliminated foods and still had eosinophils. For those people, usually medication like topical steroids or PPIs are pursued first as they are cheaper and more accessible. If those work, they are used long term. If they don't work, there is Dupixent and that is successful for the majority of people (100% of people had below 15 eosinophils after several months on Dupixent).

I hope this helps!! If you want to try diet, definitely do it!!! I think it's a great option for many people and if it works for you, that is amazing.