Hello David, I have a new client with Eosinophilic Esophagitis (EOE) diagnosed by a gastrologist via endoscopy. From my research, I've gathered it's an inflammatory immune response of increased eosinophils in the esophagus due to exposure to an allergen, most likely food-related. Her only symptom is feeling like something is constantly stuck in her throat, and it is the worst upon waking. My client has had extensive allergy testing and all results have come back normal. GERD has also been ruled out, so her doctor referred her to a nutritionist (me). We've uncovered that this sensation seems to worsen a few hours after eating dairy, so she will first be eliminating dairy from her diet for a few weeks to see if this sensation improves. This will be followed by eliminating other major allergens if there is no improvement with eliminating dairy. She also has vulvadynia, another inflammatory condition linked to excess immune response, so there is seemingly a pattern. As an Herbalist, I'd like to address her excessive immune response alongside the elimination diet. The first things that come to mind are immune amphoterics and regulators to calm down excessive immune reponse, alteratives to support elimination, and anti-inflammatories. Am I on the right track? Have you ever had a client with EOE, and are there herbs that are more specifically indicated for this condition? Her description of her experience of EOE sounds a bit like plum pit syndrome, but I am unsure if the 2 are related. Thank you for your time, Lynn Roberts

We’ve uncovered that this sensation seems to worsen a few hours after eating dairy, so she will first be eliminating dairy from her diet for a few weeks to see if this sensation improves. - (not long enough it needs to be at least 6-8 weeks) This will be followed by eliminating other major allergens if there is no improvement with eliminating dairy. She also has vulvodynia, another inflammatory condition linked to excess immune response, so there is seemingly a pattern. Not necessarily Am I on the right track? Yes but chose the right herbs in each category , if you want this to be effective, for example immune-regulatory herbs I would consider Turmeric and Gotu Kola Have you ever had a client with EOE, and are there herbs that are more specifically indicated for this condition? Yes, I have treated people with it , but there are no specific herbs for this, it really depends on the specific person and the specific symptoms Her description of her experience of EOE sounds a bit like plum pit syndrome, but I am unsure if the 2 are related. It very well could be what in TCM is called plum pit syndrome. PPS is often caused by phlegm stagnation and heat (inflammation) , leading to stuck qi. It can have physiological or psychological causes, herbs for this include ban xia, ginger, Poria, Magnolia bark and Perilla leaf. TCM Pattern Differentiation Liver Qi and Phlegm Stagnation in the Throat , Shen Irritable Feeling of something stuck in the throat and difficulty clearing it out by coughing or swallowing, depression, anxiety, easily angered and moody, chest pressure or abdominal distention Tongue : pink tongue, white coat Pulse : wiry Acupuncture Treatment : CV-17, CV-22, CV-23, LR-2, LR-3, PC-6, ST-36, ST-40, SP-9 Phlegm Qi Depression and Binding Feeling of something caught in the back of the throat which can neither be spit up or swallowed down, chest and abdominal fullness and oppression, profuse phlegm, irritability, possible PMS, menstrual irregularity, or fibrocystic lumps in the breast in females. Tongue : slimy white coat Pulse : slippery, bowstring Treatment Principle : Move the Qi and downbear counterflow, transform phlegm and disinhibit the throat Acupuncture Treatment: LR-3, PC-6, ST-40, ST-36, CV-17, CV-12, CV-22. Phlegm Heat Harassing Feeling of something caught in the back of the throat which can neither be spit up or swallowed down, chest and abdominal fullness and oppression, profuse phlegm, irritability, possible PMS, menstrual irregularity, or fibrocystic lumps in the breast in females. Tongue : red tongue, slimy yellow coat Pulse : slippery, bowstring, rapid Treatment Principle : Clear Heat and transform phlegm, resolve depression and disinhibit the throat Acupuncture Treatment: LR-2, ST-41, ST-40, CV-22, CV-17, CV-12. Yin Vacuity-Liver Depression Feeling of something caught in the back of the throat which can neither be coughed up or swallowed down, dry mouth and throat, 5-palm heat, lingering rib-side pain, possible menstrual pain or PMS, possible scanty, delayed, or blocked menstruation Tongue : red tongue, scanty coat Pulse : slippery, bowstring, rapid Treatment Principle : Principle: Enrich Yin and downbear fire, emolliate the liver and scatter nodulation Acupuncture Treatment: Tonify: LU-7, KI-6, SP-6; Even technique: LR-3, LR-14, CV-22, ST-40 Lung-Kidney Yin Vacuity, Phlegm Fire Flaring Upward Feeling of something caught in the back of the throat which can neither be spit up or swallowed down, dry mouth and throat, thirst but no great desire to drink, 5-palm heat, afternoon tidal heat, possible night sweats, possible palpitations, vexation and agitation, insomnia, tinnitus, dizziness Tongue : red tongue, dry and/or scanty, possibly yellow coat Pulse : bowstring, fine, rapid Treatment Principle : Nourish the lungs and enrich the kidneys, clear heat and disinhibit the throat Acupuncture Treatment: LU-7, KI-6, SP-6, ST-40, St-44, CV-22. Even technique Blood Stasis Obstructing the Network Vessels Feeling of something caught in the back of the throat which can neither be spit up or swallowed down, chest, rib-side, or abdominal fixed or piercing pain, possible menstrual irregularity and/or dysmenorrheal in females, enduring disease worse symptoms get worse in the afternoon or evening, spider nevi or varicosities, dark dusky complexion Tongue : dark purplish tongue or possible static spots and macules Pulse : bowstring, choppy, possibly bound Treatment Principle : Quicken the Blood and transform stasis, free the flow of the network vessels and disinhibit the throat Acupuncture Principle : LU-7, KI-6, SP-6, ST-40, St-44, CV-22.