Epipharyngeal Abrasive Therapy (EAT)
Understanding Epipharyngeal Abrasive Therapy (EAT) and Its Role in Long COVID Management
In the wake of the COVID-19 pandemic, the medical community has been tirelessly working to understand and manage the long-term effects of the virus, commonly referred to as Long COVID or Post-COVID Conditions (PCC). Among the various therapeutic interventions under exploration, Epipharyngeal Abrasive Therapy (EAT) has emerged as a topic of interest, albeit with limited application in the United States. This comprehensive guide aims to shed light on EAT, its potential benefits for individuals suffering from dysautonomia and Long COVID, and the pioneering work of Dr. Robert Groysman MD in this field.
What does EAT help with?
The majority of people with long covid also have chronic epipharyngitis. Epipharyngitis is not always symptomatic, but many if not all people who suffer from long covid likely have it. It is responsible for causing many of the long covid symptoms. The immune system continues to respond as a residual response causing neuroexcitatory molecules such as TNF-alpha, INF-delta, and IL-1 in the brain resulting in a low level and chronic inflammation. Symptoms like headaches, system wide pain, fatigue, dizziness, throat pain, postnasal drip, and a chronic cough are also seen. EAT has several effects:
- Direct stimulation of the vagus nerve endings
- decreased secretion of inflammatory cytokines
- suppression of inflammatory cell aggregation
What symptoms does EAT address?
- postnasal drip, runny nose
- irritated throat, headaches, nasal irritation
- nasal congestion
- eustachian tube dysfunction, hearing loss, tinnitus
- dizziness, vertigo, light headedness
- hoarseness, voice changes
- cough, sore throat
- snoring, insomnia, daytime sleepiness
- acid reflux, heartburn
- fatigue, brain fog, depression
Dr. Groysman was featured on ABC News. For more information here.
Dr. Groysman was featured on Fox26.
EAT Procedure FAQ's
Right now, Dr. Groysman is the only physician outside of Japan that offers this procedure on a regular basis.
In general it takes 10-15 minutes to complete the procedure. It takes a few extra minutes to numb up the back of the nose.
We numb the inside of the nose using a topical numbing spray that has lidocaine. The procedure is well tolerated awake by most.
The size of the nostrils doesn’t actually matter. The flexible endoscope camera is 3.8 mm and can fit thru the narrowest of nostrils.
Yes, even kids tolerate this procedure awake. If sedation is required, we can call something oral in before the procedure.
Yes you can have both procedures done on the same day, just not at the same time.
Yes. Its preferable to wait 1-2 weeks after recovering from a cold, flu or COVID before having the EAT procedure.
It may be repeated as many times as needed.
In general, Dr. Groysman recommends waiting 5-7 days between procedures to allow the epipharyngeal area to heal between treatments.
It does not. There is no CPT code to bill even for this procedure.
You can. We can call in an oral sedative for you to take 30 minutes before the procedure. You will still be awake but more relaxed for those that tend to be anxious.
Nothing specific is needed. If you have seasonal or respiration allergies, take your usual medications.
It has 4 mechanisms that work:
- direct cleaning from abrasion – kind of spring cleaning of the back of your nose and throat.
- stimulation of the vagus nerve endings
- decreased inflammatory cytokines
- improved dysautonomia symptoms
You may experience some discomfort of burning in the back of your nose. The amount depends on how inflamed your epipharynx is. Soreness typically lasts for 1-2 days after the procedure. One idea to reduce this is to use a regular saline nasal spray and gargling with a 1/2 teaspoon of salt dissolved in warm water.
It will treat any ENT problems such as pressure headaches, face pain, stuffy nose, post nasal drip, as well as those caused by dysautonomia. It may also help with CFS/ME. Dr. Groysman believes that the EAT procedure works synergistically with the SGB procedure. It can treat the missing gaps that SGB misses.
It all depends on how inflamed the epipharynx is initially. Some will d o fine with 1-2. Others will need 4 or more.
What is Epipharyngeal Abrasive Therapy (EAT)?
Epipharyngeal Abrasive Therapy (EAT) is a medical procedure designed to stimulate the immune response by causing a controlled abrasion in the epipharynx area of the throat. The therapy is based on the premise that this minor irritation can lead to an enhanced immune response, potentially aiding in the recovery of various conditions, including viral infections.
Historical Context and Usage
The concept of utilizing irritation or minor injury to bolster the body’s immune response is not new and has been a part of traditional healing practices for centuries. However, the formalization of EAT as a therapeutic intervention is relatively recent, with its application being more common in certain parts of Europe and Asia than in the United States. The exact duration of its usage in medical practice is hard to pinpoint, but it has garnered attention in recent years as a potential tool in managing viral illnesses, including COVID-19.
Mechanism of Action
EAT operates on the principle of inducing a controlled inflammatory response. By causing a small abrasion in the epipharynx, the therapy aims to kickstart the body’s immune mechanisms, potentially leading to an improved ability to fight off infections or manage autoimmune responses. This approach is thought to be beneficial in conditions where the immune system’s regulation plays a critical role.
Availability in the United States
Despite its intriguing potential, EAT is not commonly practiced in the United States. In fact, as of this writing, the only physician who offers this procedure outside of Japan is Dr. Groysman. Treating dysautonoma and long covid since it started, Dr. Groysman sees the huge potential of the EAT procedure, especially combined with the SGB procedure.
Combination Treatment for Dysautonomia and Long COVID
Dysautonomia refers to a range of conditions that involve dysfunction of the autonomic nervous system, which controls involuntary bodily functions such as heart rate, blood pressure, and digestion. Long COVID, on the other hand, encompasses a wide array of symptoms and conditions that persist for weeks or months after the acute phase of the COVID-19 infection has resolved. Both dysautonomia and Long COVID share a common thread in that they can significantly impact the quality of life and are challenging to manage due to their complex, multifaceted nature.
The Role of Stellate Ganglion Block (SGB) in Managing Long COVID
The Stellate Ganglion Block (SGB) is a procedure that involves the injection of a local anesthetic into the stellate ganglion, a collection of nerves in the neck. This technique has been explored as a treatment for various conditions, including PTSD and certain types of pain. Recently, SGB has also been investigated for its potential benefits in managing symptoms of Long COVID, particularly those related to dysautonomia, by modulating the autonomic nervous system’s response.
Synergistic Potential of EAT and SGB
Combining EAT with SGB could offer a multifaceted approach to managing Long COVID, particularly for individuals experiencing dysautonomia. EAT’s potential to enhance the immune response, coupled with SGB’s ability to modulate the autonomic nervous system, presents a promising avenue for alleviating some of the complex symptoms associated with Long COVID. This combination therapy could theoretically address both the immune and autonomic dysfunctions observed in some patients, although further research is needed to fully understand its efficacy and safety.
Dr. Robert Groysman MD and His Contributions
Dr. Robert Groysman MD is a medical professional whose work has significantly contributed to the understanding and management of Long COVID and dysautonomia. His research and clinical practice have focused on innovative approaches to these conditions, exploring therapies like EAT and SGB as potential tools in the comprehensive care of affected individuals. Dr. Groysman’s dedication to finding effective treatments for Long COVID and related conditions highlights the importance of ongoing research and clinical innovation in the post-pandemic era.
Conclusion