Failed my 6fed - would love advice/feedback on my next steps

General Question

Hey all 33F here, I'll try to be brief as I recount my journey, there is a lot to chew on

Started with dysphagia and a sky high eoe count of 150 - required immediate double dosing of PPIs. the experience with omeprazole was pretty terrible. my stomach swelled to twice its normal size and i was struggling to make it through the day. But it did work - the eoe count reduced to 8 per hpf.

Excited to restart at a good baseline, I quit wheat and dairy and got another scope. My counts rose to 35. Not the insane 150 I saw before, but not great. So I'm pretty sure either wheat or dairy was a trigger.

Tried budesonide but got scared off it cause of thrush happening within the first few weeks. I don't quite know if it worked or didnt work. I elected to to a full 6fed to try to flush out the trigger

after 6 weeks of 6fed, my counts didnt meaningfully change. I read in some literature the next"step up" elim is rice, and all meats. However, at this point I am debating the elemental diet and going full food elim.

My choices basically are

-elemental and slow re introduction. Luckily I am working with a good doctor who has access to the string test, so I can get that instead of annoying endoscopies every 6 weeks

-try budesonide and fight through the thrush

-dupixent

-A different PPI thats less volatile than omeprazole

My doctor gave me time to think about it and he said he would support the path I wanted for myself. Emotionally, I feel like I like the idea of full elimination, even though it would suck, because at least I can understand what the trigger actually is. Plus, between how cheap amino acid powders are, I can DIY my own elemental powder for only 300 bucks a month vs the 2000 the brand names would charge. it annoys me no end to just..not know. It would be a shitty six weeks, but I could know for sure afterwards what this minor trigger is.

I'm wondering for anyone else who failed the 6fed, what they did and how happy they are with their choice. Thanks! Good luck!

Posted Apr 1, 2026, 8:37 PM UTC

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