An 11-year-old boy suffering from a rare and incurable disease has to undergo surgery every two to three months to find which foods are causing his severe allergic reactions.
Caleb Hoshaw was diagnosed with eosinophilic esophagitis after constant vomiting, originally misdiagnosed as acid reflux, turned out to be severe inflammation in his esophagus.
Doctors discovered that any one of the foods Caleb had been eating his entire life were causing a build up of acid that destroyed parts of his esophagus and the nerves in his throat, making him unable to feel when he's choking on something.
Now the only way for the fifth grader from Kansas to know which foods are triggering his illness is by process of elimination: Caleb has to eat only meals from one food group at a time for nine to 12 weeks until his doctors have determined which of the eight groups is making him sick.
At the end of each three month period, doctors have to biopsy his esophagus, stomach and small intestines to see if the most recent food group damaged them - a process that could take more than two years.
Caleb Hoshaw, 11, was diagnosed with a rare and incurable condition called eosinophilic esophagitis in December 2016
For nine to 12 weeks he will introduce one new food group ending in a surgery to learn if that one food is a trigger - then he will start the process again
Caleb's mother Linda Hoshaw told Daily Mail Online that her son showed signs of this condition from infancy when he could not tolerate formula and had issues swallowing.
He was diagnosed with acid reflux and has been on medication to control it his whole life.
'From the time he was born until four years old he had a swallowing issue so we pureed some things he ate and drank,' she said.
This is why when Caleb experienced sporadic episodes of vomiting Linda attributed it to the acid reflux and dehydration from sports.
However, in the fall of 2016 Linda took son to specialists when the vomiting became more frequent and Caleb complained of food feeling stuck in his chest.
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ShareBy December of that year, biopsies of his throat determined that Caleb suffered from eosinophilic esophagitis (EOE), a chronic allergic and immune condition that causes inflammation of the esophagus.
Those who suffer from EOE have a large number of eosinophils—a type of white blood cell that is normally found in small numbers in the blood.
The disorder affects one to four in 10,000 people in the United States.
WHAT IS EoE?
EoE is an allergic inflammatory condition of the esophagus, the tube that connects the mouth to the stomach.
The condition is caused when a type of white blood cell (an eosinophil) builds up in the esophagus as a reaction to foods or allergens.
They attack the foods, rather than allowing them to be ingested. As they build up, the eosinophils can inflame or injure the tissue, causing swallowing problems.
It can be treated with modifying the diet to exclude certain foods, by taking steroid medications to reduce the swelling or by mechanically widening the esophagus.
EoE was only discovered in recent years so little is known about its exact cause.
<!- - ad: https://mads.dailymail.co.uk/v8/us/health/none/article/other/mpu_factbox.html?id=mpu_factbox_1 - ->AdvertisementDoctors told the family that Caleb was born with the condition and years of acid build up had burned the nerves in his esophagus so badly that he now has no feeling in his throat.
'He doesn't have the feeling of knowing he's choking,' Linda said.
Choking is one of the symptoms of the disease, but went undetected due to the affected nerves.
The fifth grader learned that the foods he loved - pancakes, eggs, french toast - had all been eroding his esophagus over the year.
There is no cure for this condition, only treatment to find out which foods trigger the increase in white blood cells that will let Caleb know which to stay away from for the rest of his life.
The treatment includes eliminating common food groups, known as 'The Top 8' for nine to 12 weeks.
Those foods include wheat, milk, egg, soy, peanuts, tree nuts, fish, and shellfish.
He has eliminated all of those and will only reintroduce one of the food groups at a time for a nine to 12-week period.
At the end of the two to three months, he will have surgery of about 17 biopsies of his esophagus, stomach and his small intestines to see if the foods have triggered the disease in any of those areas.
His mother Linda Hoshaw told Daily Mail Online that her sign was likely born with the condition and was misdiagnosed with acid reflux his entire life
The condition means most of the food Caleb ate his whole life caused inflammation in his esophagus making him vomit and has eroded parts of his throat
So far Caleb has passed the wheat test, meaning he now can enjoy bread and biscuits.
However, another three-month test found that dairy is a trigger, meaning he can no longer eat ice cream and cheese without ruining his intestines.
While there should be nearly no eosinophils in the tissue of the esophagus, biopsies found Caleb had 225 of the white blood cells due to dairy.
The diagnosis has been a big lifestyle change for Caleb and his family that includes his mother, father and 12-year-old sister.
She added the birthdays, school lunches and family holidays such as Thanksgiving are difficult for her son.
Cross-contamination of foods is a big worry for the family because if Caleb 'cheats' and accidentally eats food from one of the other eight groups, he has to start the nine to 12 week process from scratch.
Right now Caleb is limited to eating all fresh foods including fruits, vegetables and meats.
Linda said his 'go-to's' are spaghetti and tacos.
Next Caleb will introduce egg for three months before having the biopsy to reveal how his body reacts to the foods.
'We're going to do eggs next because he wants those brownies and breakfast back,' said Linda.
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