How is eosinophilic esophagitis treated?

How is eosinophilic esophagitis treated?

There are two main treatment approaches to eosinophilic esophagitis: medications and dietary management.

Medication approaches: Antacid medications, called proton pump inhibitors, and steroids are the most commonly used medication for both the control of the inflammation and direct suppression of the eosinophils. Proton-pump inhibitors can be taken orally (in pill form) while steroid medications are taken topically (swallowed, liquid medications). These medications need to be taken for a long time to keep the inflammation from coming back. For some people, continued use of steroids can cause Candida infections (yeast infections of the mouth and esophagus) as a side effect.

Dietary management: Some healthcare professionals think food allergies may be a cause of eosinophilic esophagitis. However, the foods which might be the cause are still unknown. The more common foods associated with food allergies in general are milk, eggs, nuts, beef, wheat, fish, shellfish, corn and soy. In the case of eosinophilic esophagitis, a single food may cause problems in some people, and many foods may be the cause in others.

Several dietary approaches can be tried. Under a "targeted" approach, foods are eliminated from the diet one at a time, based on allergy testing. Unfortunately, typical allergy tests, such as skin prick tests or blood tests, are not usually effective in finding the problem foods that are responsible for eosinophilic esophagitis. So another type of elimination diet – cutting the common foods mentioned above – is the usual approach.

With any of these food trial diets, foods are slowly brought back into the diet to try to discover which ones are causing the allergic reaction. The patient will have to have more biopsy and endoscopic examinations to determine which foods aren’t causing the problems.

Other non-drug approaches: Another treatment that has been tried for some people is esophageal dilatation. This is a procedure in which the doctor dilates (stretches) the esophagus, either during an endoscopy or in a separate procedure. This is tried specifically in patients who get food stuck in their esophagus.