Eosinophilic esophagitis medical therapy

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Eosinophilic Esophagitis Microchapters


Patient Information


Historical Perspective




Differentiating Eosinophilic Esophagitis from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


History and Symptoms

Physical Examination

Laboratory Findings

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Other Imaging Findings

Other Diagnostic Studies


Medical Therapy


Primary Prevention

Secondary Prevention

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Ajay Gade MD[2]]


The optimal treatment of eosinophilic esophagitis remains uncertain. An eight-week course of therapy with topical corticosteroids (fluticasone or budesonide) may be used as the first-line pharmacologic therapy. Allergen elimination usually leads to improvement in dysphagia and reduction of eosinophil infiltration. Esophageal dilation of is generally reserved for refractory cases with esophageal stricture.

Medical Therapy

Steroid Therapy

Dietary Modification

  • The dietary strategies are as follows:
  • Elemental diet- highly effective in both adults and children, but it is limited by patient tolerability.
  • Empiric six-food elimination diet (SFED)- the most common foods that trigger EoE are: soy, fish, cow milk, nuts, eggs, wheat.
  • Limited diet driven by allergy testing and patient history- The allergy testing directs diet approach, although effective in the pediatric group has only moderate success in adults.
  • The goal of dietary therapy is identification and removal of food antigens and consequently remove the sensitization.
  • Diet therapy gives patients an alternative to control their disease, many patients find the idea of managing their sickness by means of removing the nutritional trigger more appealing than taking a drug to counteract the downstream inflammatory response.
  • It is far vital to emphasize that the stern dietary elimination of multiple foods is only for a limited time but the long-term goal is the identify and remove the triggering dietary elements.
  • Prolonged deviation from the elimination diet can be managed via the intermittent use of quick courses of topical steroids.

Esophageal Dilation


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