Materiały źródłowe

• #1 Eosinophilic Esophagitis: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/digestive/esophageal-diseases/eosinophilic-esophagitis/treatment

  Eosinophilic esophagitis is a lifelong disease whose symptoms can come and go. It is helpful to learn the triggers of your symptoms so you can avoid them. […] The most effective therapies to reduce or prevent symptoms include dietary changes, medications, and when needed, dilation of the esophagus if it becomes constricted.

• #2 Eosinophilic Esophagitis – familydoctor.org

  https://familydoctor.org/condition/eosinophilic-esophagitis/

  You cannot prevent or avoid EoE. It may run in families. […] There is no cure for EoE. The goal of treatment is to relieve symptoms and prevent further damage.

• #3 What Is Eosinophilic Esophagitis (EoE)? Symptoms, Causes, Diagnosis, and Treatment

  https://www.everydayhealth.com/eosinophilic-esophagitis/

  Theres no way to prevent EoE from developing, but there are effective strategies to manage your symptoms, according to the American Academy of Allergy, Asthma Immunology. […] Be sure to follow the dietary plan you and your doctor select. Deviating from the diet even a little can lead to inflammation of the esophagus. Whats more, it may take days or weeks for a food-related reaction to occur.

• #4 Management of Eosinophilic Esophagitis

  https://www.aap.org/en/patient-care/eosinophilic-esophagitis/management-of-eosinophilic-esophagitis/?srsltid=AfmBOootEBqpYDWF7xWQAbMJXUNqDxWPSXDmCIpQWp1CIpkqU0LJRlde

  EoE is a chronic disease that requires long-term treatment. The goals of treatment are to: […] Prevent disease complications (malnutrition, suboptimal growth)). […] Treating children with EoE involves diet therapy and/or medical therapy. […] A multi-center, retrospective study drawing from a European database of patients with EoE (adults and children) demonstrated that clinical and histologic remission or response occurred in 82% of patients taking topical steroids, 69% of patients taking proton pump inhibitors, and 42% of patients on empirical elimination diets. […] Recent guidelines promote shared decision making and individualized approaches towards management. […] For many children, EoE is a non-IgE-mediated allergic disease, thus removal of relevant food allergens can cause remission of the disease.

• #5 Spreading eosinophilic esophagitis awareness and wellness in patients – Bristol Myers Squibb

  https://www.bms.com/life-and-science/science/spreading-eosinophilic-esophagitis-awareness-and-wellness-in-patients.html

  Addressing the underlying inflammation and fibrosis and doing so early in the course of the disease is key to preventing serious complications and improving how patients feel. […] We are dedicated to making a meaningful impact on EoE treatment by working to advance patient care.

• #6 What can help treat eosinophilic esophagitis?

  https://www.medicalnewstoday.com/articles/eosinophilic-esophagitis-treatment

  Eosinophilic esophagitis treatment aims to decrease symptoms, prevent damage to the esophagus, and improve quality of life. […] In many people, an abnormal immune reaction to certain foods is the main cause of eosinophilic esophagitis. This is why a healthcare professional may recommend an elimination diet. […] An individual stops eating the foods listed above for several weeks. After a few weeks, they add foods back one by one to determine what food triggered the allergic reaction. […] The formula replacement may continue for 6 weeks to allow the esophagus to heal. Foods less likely to cause an allergic response are then gradually reintroduced. […] Treatment aims to stop inflammation, reduce symptoms, and improve swallowing. Treatment options may include elimination diets to determine the food trigger. Doctors may also prescribe medications, such as corticosteroids, proton pump inhibitors, or Dupilumab, to help reduce inflammation.

• #7 Ask the dietitian: Dietary management for those with Eosinophilic Esophagitis (EoE) – Food Allergy Canada

  https://allergiesalimentairescanada.org/ask-the-dietitian-dietary-management-for-those-with-eosinophilic-esophagitis-eoe/

  For people diagnosed with EoE, we know that food proteins can drive the inflammation of the esophagus, and that food elimination diets can be effective treatment. The most common food triggers of EoE in North America are milk, wheat/gluten, soy, egg, peanut/tree nuts, and fish/shellfish. If you would like to try an elimination diet as treatment of your EoE, you can discuss this option with your gastroenterologist. […] Wheat is the grain commonly used in foods like bread, pasta, etc., and it naturally contains many different types of protein. Gluten is a type of protein found in wheat that is also found in barley and rye. We know that wheat is the second-most common trigger of EoE (after milk) and that eliminating it as part of a food elimination diet can be an effective treatment. […] If you are starting an elimination diet for treatment of your EoE, it’s important to discuss the plan with your dietitian and gastroenterologist so everyone is in agreement with what should be avoided in your diet.

• #8 Ask the dietitian: Dietary management for those with Eosinophilic Esophagitis (EoE) – Food Allergy Canada

  https://allergiesalimentairescanada.org/ask-the-dietitian-dietary-management-for-those-with-eosinophilic-esophagitis-eoe/

  The most effective elimination diet is the most difficult one to do; it is called the elemental diet and involves drinking a specialty formula instead of eating regular foods. There is also the six food elimination diet which involves eating regular food but avoiding the six most common allergens: milk, wheat/gluten, soy, egg, peanut/tree nuts, fish/shellfish. Other elimination diets include: the four food elimination diet (milk, wheat/gluten, soy, egg), the one food elimination diet (milk) and the step-up elimination diet (begins with milk and wheat/gluten elimination).

• #9 Eosinophilic Esophagitis: Management Guidelines from the AGA and JTF | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0501/p573.html

  Food elimination based on allergy testing resolves esophageal inflammation in one-half of patients. […] An empiric six-food elimination diet resolves inflammation in two-thirds of patients. Eliminating foods based on allergy testing results is simple and resolves inflammation in one-half of patients. […] The primary treatments for eosinophilic esophagitis include proton pump inhibitors and topical steroids. Topical steroids are more effective than proton pump inhibitors, resolving inflammation in two-thirds of patients, more than four times the placebo response.

• #10 Management of eosinophilic esophagitis (EoE) – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/management-of-eosinophilic-esophagitis-eoe/

  1. In patients with symptomatic esophageal eosinophilia, AGA and the Joint Task Force on Allergy-Immunology Practice Parameters (JTF) suggests using proton pump inhibition over no treatment. […] 2. In patients with eosinophilic esophagitis (EoE), AGA/JTF recommends topical glucocorticosteroids over no treatment. […] 3. In patients with EoE, AGA/JTF suggests topical glucocorticosteroids rather than oral glucocorticosteroids. […] 4. In patients with EoE, AGA/JTF suggests using elemental diet over no treatment. […] 5. In patients with EoE, AGA/JTF suggests using an empiric, six-food elimination diet over no treatment. […] 6. In patients with EoE, AGA/JTF suggests using an allergy testing-based elimination diet over no treatment. […] 7. In patient with EoE in remission after short-term use of topical glucocorticosteroids, AGA/JTF suggests continuation of topical glucocorticosteroids over discontinuation of treatment.

• #11 Management of Eosinophilic Esophagitis

  https://www.aap.org/en/patient-care/eosinophilic-esophagitis/management-of-eosinophilic-esophagitis/?srsltid=AfmBOootEBqpYDWF7xWQAbMJXUNqDxWPSXDmCIpQWp1CIpkqU0LJRlde

  It is important to acknowledge that elimination diets can be difficult to adhere to and can decrease quality of life and possibly promote disordered eating. […] Although the elemental diet is a useful method to achieve remission, its use in chronic therapy is limited because of the difficulty in maintaining the diet. […] The SFED relies on eliminating the most frequent allergic triggers, of which milk is the most common trigger (61%). […] Implementing the diet requires motivation and involves understanding several factors and procedures: […] Once remission is achieved with the diet, the child can add in one food over the course of several weeks, after which time biopsy can be used to determine whether remission is maintained. […] The diet is not easy to maintain, and care must be taken to control the child’s food exposures in all settings, including:

• #12 Forgoing one food treats eosinophilic esophagitis as well as excluding six | National Institutes of Health (NIH)

  https://www.nih.gov/news-events/news-releases/forgoing-one-food-treats-eosinophilic-esophagitis-well-excluding-six

  Eliminating animal milk alone from the diet of adults with eosinophilic esophagitis, or EoE, is as effective at treating the disease as eliminating animal milk plus five other common foods, a clinical trial funded by the National Institutes of Health has found. […] For people with EoE whose disease remains active after they forgo animal milk, a more restrictive diet may help them achieve remission, according to the researchers. […] Diet-based therapy for eosinophilic esophagitis will be much easier to follow for many people if it involves cutting just one food from the diet rather than six, said Hugh Auchincloss, M.D., acting director of the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH. […] The researchers also discovered that nearly half of people who did not respond to 1FED attained remission after treatment with the more restrictive 6FED, while more than 80% of the non-responders to 6FED achieved remission with oral steroids. […] Taken together, the investigators conclude that 1FED is a reasonable first-line diet therapy option in adults with EoE, and that effective therapies are available for people who do not achieve remission after 1FED or 6FED.

• #13 Forgoing one food treats eosinophilic esophagitis as well as excluding six | National Institutes of Health (NIH)

  https://www.nih.gov/news-events/news-releases/forgoing-one-food-treats-eosinophilic-esophagitis-well-excluding-six

  Eliminating animal milk alone from the diet of adults with eosinophilic esophagitis, or EoE, is as effective at treating the disease as eliminating animal milk plus five other common foods, a clinical trial funded by the National Institutes of Health has found. […] For people with EoE whose disease remains active after they forgo animal milk, a more restrictive diet may help them achieve remission, according to the researchers. […] Diet-based therapy for eosinophilic esophagitis will be much easier to follow for many people if it involves cutting just one food from the diet rather than six, said Hugh Auchincloss, M.D., acting director of the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH. […] The researchers also discovered that nearly half of people who did not respond to 1FED attained remission after treatment with the more restrictive 6FED, while more than 80% of the non-responders to 6FED achieved remission with oral steroids. […] Taken together, the investigators conclude that 1FED is a reasonable first-line diet therapy option in adults with EoE, and that effective therapies are available for people who do not achieve remission after 1FED or 6FED.

• #14 What can help treat eosinophilic esophagitis?

  https://www.medicalnewstoday.com/articles/eosinophilic-esophagitis-treatment

  Eosinophilic esophagitis treatment aims to decrease symptoms, prevent damage to the esophagus, and improve quality of life. […] In many people, an abnormal immune reaction to certain foods is the main cause of eosinophilic esophagitis. This is why a healthcare professional may recommend an elimination diet. […] An individual stops eating the foods listed above for several weeks. After a few weeks, they add foods back one by one to determine what food triggered the allergic reaction. […] The formula replacement may continue for 6 weeks to allow the esophagus to heal. Foods less likely to cause an allergic response are then gradually reintroduced. […] Treatment aims to stop inflammation, reduce symptoms, and improve swallowing. Treatment options may include elimination diets to determine the food trigger. Doctors may also prescribe medications, such as corticosteroids, proton pump inhibitors, or Dupilumab, to help reduce inflammation.

• #15 Eosinophilic Esophagitis: Causes, Treatment, and Diet

  https://www.healthline.com/health/eosinophilic-esophagitis

  The best way to prevent food impactions is to see a doctor regularly, even if you feel well, and for urgent follow-ups if your EoE symptoms are flaring. You should also follow their guidance for managing EoE. […] Because eosinophilic esophagitis could be caused or worsened by an allergic response to certain foods, your treatment may include eliminating those foods from your diet. […] If you have a known food allergy based on pinprick testing, your doctor will most likely start by recommending that you eliminate that food right away. […] In an elimination diet, you would completely remove all these foods from your diet and then slowly reintroduce them one by one to determine whether you’re sensitive to any of them. […] However, dilation is done on an as-needed basis when eosinophilic esophagitis gets serious enough to cause narrowing of the esophagus and make swallowing difficult. This procedure does not prevent the buildup of eosinophils. It just relieves the constriction long enough to hopefully allow other remedies to prevent the condition from progressing.

• #16 Management of Eosinophilic Esophagitis

  https://www.aap.org/en/patient-care/eosinophilic-esophagitis/management-of-eosinophilic-esophagitis/?srsltid=AfmBOootEBqpYDWF7xWQAbMJXUNqDxWPSXDmCIpQWp1CIpkqU0LJRlde

  It is important to acknowledge that elimination diets can be difficult to adhere to and can decrease quality of life and possibly promote disordered eating. […] Although the elemental diet is a useful method to achieve remission, its use in chronic therapy is limited because of the difficulty in maintaining the diet. […] The SFED relies on eliminating the most frequent allergic triggers, of which milk is the most common trigger (61%). […] Implementing the diet requires motivation and involves understanding several factors and procedures: […] Once remission is achieved with the diet, the child can add in one food over the course of several weeks, after which time biopsy can be used to determine whether remission is maintained. […] The diet is not easy to maintain, and care must be taken to control the child’s food exposures in all settings, including:

• #17 What Is Eosinophilic Esophagitis (EoE)? Symptoms, Causes, Diagnosis, and Treatment

  https://www.everydayhealth.com/eosinophilic-esophagitis/

  Theres no way to prevent EoE from developing, but there are effective strategies to manage your symptoms, according to the American Academy of Allergy, Asthma Immunology. […] Be sure to follow the dietary plan you and your doctor select. Deviating from the diet even a little can lead to inflammation of the esophagus. Whats more, it may take days or weeks for a food-related reaction to occur.

• #18 Management of Eosinophilic Esophagitis

  https://www.aap.org/en/patient-care/eosinophilic-esophagitis/management-of-eosinophilic-esophagitis/?srsltid=AfmBOootEBqpYDWF7xWQAbMJXUNqDxWPSXDmCIpQWp1CIpkqU0LJRlde

  Dietary restrictions are well known to reduce quality of life; however, a multidisciplinary approach available in an EoE clinic can anticipate and address these aspects. […] In consensus guidelines, the failure to respond to PPIs has been removed as a criterion for ruling out a diagnosis of EoE because some patients with EoE improve with PPI therapy. […] PPIs may be considered first-line therapy for EoE, before elimination diets are recommended and before topical steroids are considered. […] Swallowed topical glucocorticoids taken in a small amount of liquid or a puff from an inhaler are the mainstay treatment option to medically treat inflammation; remission rates are high with this method. […] Dupilumab, a monoclonal antibody to IL-4 receptor alpha, is the first biologic treatment for EoE approved by the FDA. […] When dietary or anti-inflammatory treatment are ineffective, children with EoE may develop esophageal strictures or stenosis. […] In some children, esophageal dilation may be necessary to prevent food impaction and pain.

• #19 Ask the dietitian: Dietary management for those with Eosinophilic Esophagitis (EoE) – Food Allergy Canada

  https://allergiesalimentairescanada.org/ask-the-dietitian-dietary-management-for-those-with-eosinophilic-esophagitis-eoe/

  For people diagnosed with EoE, we know that food proteins can drive the inflammation of the esophagus, and that food elimination diets can be effective treatment. The most common food triggers of EoE in North America are milk, wheat/gluten, soy, egg, peanut/tree nuts, and fish/shellfish. If you would like to try an elimination diet as treatment of your EoE, you can discuss this option with your gastroenterologist. […] Wheat is the grain commonly used in foods like bread, pasta, etc., and it naturally contains many different types of protein. Gluten is a type of protein found in wheat that is also found in barley and rye. We know that wheat is the second-most common trigger of EoE (after milk) and that eliminating it as part of a food elimination diet can be an effective treatment. […] If you are starting an elimination diet for treatment of your EoE, it’s important to discuss the plan with your dietitian and gastroenterologist so everyone is in agreement with what should be avoided in your diet.

• #20 Medications for Eosinophilic Esophagitis

  https://www.webmd.com/digestive-disorders/eoe-medications

  While theres no cure for eosinophilic esophagitis (EoE), there are several medications doctors prescribe to control symptoms, ease inflammation, and prevent further damage. […] Most patients respond well to this treatment. […] While all of these drugs work, you need to take them every day to see benefits. Once you stop, your symptoms will come back. Your doctor may put you on a lower dose for maintenance. […] It led to a significant reduction in common EoE symptoms like trouble swallowing.

• #21 Management of Eosinophilic Esophagitis

  https://www.aap.org/en/patient-care/eosinophilic-esophagitis/management-of-eosinophilic-esophagitis/?srsltid=AfmBOootEBqpYDWF7xWQAbMJXUNqDxWPSXDmCIpQWp1CIpkqU0LJRlde

  Dietary restrictions are well known to reduce quality of life; however, a multidisciplinary approach available in an EoE clinic can anticipate and address these aspects. […] In consensus guidelines, the failure to respond to PPIs has been removed as a criterion for ruling out a diagnosis of EoE because some patients with EoE improve with PPI therapy. […] PPIs may be considered first-line therapy for EoE, before elimination diets are recommended and before topical steroids are considered. […] Swallowed topical glucocorticoids taken in a small amount of liquid or a puff from an inhaler are the mainstay treatment option to medically treat inflammation; remission rates are high with this method. […] Dupilumab, a monoclonal antibody to IL-4 receptor alpha, is the first biologic treatment for EoE approved by the FDA. […] When dietary or anti-inflammatory treatment are ineffective, children with EoE may develop esophageal strictures or stenosis. […] In some children, esophageal dilation may be necessary to prevent food impaction and pain.

• #22 Management of eosinophilic esophagitis (EoE) – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/management-of-eosinophilic-esophagitis-eoe/

  1. In patients with symptomatic esophageal eosinophilia, AGA and the Joint Task Force on Allergy-Immunology Practice Parameters (JTF) suggests using proton pump inhibition over no treatment. […] 2. In patients with eosinophilic esophagitis (EoE), AGA/JTF recommends topical glucocorticosteroids over no treatment. […] 3. In patients with EoE, AGA/JTF suggests topical glucocorticosteroids rather than oral glucocorticosteroids. […] 4. In patients with EoE, AGA/JTF suggests using elemental diet over no treatment. […] 5. In patients with EoE, AGA/JTF suggests using an empiric, six-food elimination diet over no treatment. […] 6. In patients with EoE, AGA/JTF suggests using an allergy testing-based elimination diet over no treatment. […] 7. In patient with EoE in remission after short-term use of topical glucocorticosteroids, AGA/JTF suggests continuation of topical glucocorticosteroids over discontinuation of treatment.

• #23 Management of Eosinophilic Esophagitis

  https://www.aap.org/en/patient-care/eosinophilic-esophagitis/management-of-eosinophilic-esophagitis/?srsltid=AfmBOootEBqpYDWF7xWQAbMJXUNqDxWPSXDmCIpQWp1CIpkqU0LJRlde

  EoE is a chronic disease that requires long-term treatment. The goals of treatment are to: […] Prevent disease complications (malnutrition, suboptimal growth)). […] Treating children with EoE involves diet therapy and/or medical therapy. […] A multi-center, retrospective study drawing from a European database of patients with EoE (adults and children) demonstrated that clinical and histologic remission or response occurred in 82% of patients taking topical steroids, 69% of patients taking proton pump inhibitors, and 42% of patients on empirical elimination diets. […] Recent guidelines promote shared decision making and individualized approaches towards management. […] For many children, EoE is a non-IgE-mediated allergic disease, thus removal of relevant food allergens can cause remission of the disease.

• #24 Management of Eosinophilic Esophagitis

  https://www.aap.org/en/patient-care/eosinophilic-esophagitis/management-of-eosinophilic-esophagitis/?srsltid=AfmBOootEBqpYDWF7xWQAbMJXUNqDxWPSXDmCIpQWp1CIpkqU0LJRlde

  Dietary restrictions are well known to reduce quality of life; however, a multidisciplinary approach available in an EoE clinic can anticipate and address these aspects. […] In consensus guidelines, the failure to respond to PPIs has been removed as a criterion for ruling out a diagnosis of EoE because some patients with EoE improve with PPI therapy. […] PPIs may be considered first-line therapy for EoE, before elimination diets are recommended and before topical steroids are considered. […] Swallowed topical glucocorticoids taken in a small amount of liquid or a puff from an inhaler are the mainstay treatment option to medically treat inflammation; remission rates are high with this method. […] Dupilumab, a monoclonal antibody to IL-4 receptor alpha, is the first biologic treatment for EoE approved by the FDA. […] When dietary or anti-inflammatory treatment are ineffective, children with EoE may develop esophageal strictures or stenosis. […] In some children, esophageal dilation may be necessary to prevent food impaction and pain.

• #25 Treatment Options for Patients with Eosinophilic Esophagitislogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na55648/2023/01/03/treatment-options-patients-with-eosinophilic-esophagitis

  For my patients with EoE, I begin with high-dose proton-pump inhibitors, which can provide histological and clinical remission in 50% to 60% of patients. I then offer the option of an elimination diet. Based on this study, avoiding milk and wheat (and possibly soy and egg) seems appropriate for adults initially, followed by 6FED for those who do not respond. […] If food avoidance is not effective or feasible, I use swallowed fluticasone with a metered dose inhaler or swallowed budesonide mixed in Splenda or honey (≈85% of children and ≈65% of adults respond to swallowed steroids). […] For patients who don’t respond to swallowed steroids and elimination diets, dupilumab is the only current U.S. FDA-approved agent — dupilumab is even more attractive if the patient has concomitant severe eczema or asthma.

• #26 Eosinophilic Esophagitis: Management Guidelines from the AGA and JTF | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0501/p573.html

  Food elimination based on allergy testing resolves esophageal inflammation in one-half of patients. […] An empiric six-food elimination diet resolves inflammation in two-thirds of patients. Eliminating foods based on allergy testing results is simple and resolves inflammation in one-half of patients. […] The primary treatments for eosinophilic esophagitis include proton pump inhibitors and topical steroids. Topical steroids are more effective than proton pump inhibitors, resolving inflammation in two-thirds of patients, more than four times the placebo response.

• #27 Management of eosinophilic esophagitis (EoE) – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/management-of-eosinophilic-esophagitis-eoe/

  1. In patients with symptomatic esophageal eosinophilia, AGA and the Joint Task Force on Allergy-Immunology Practice Parameters (JTF) suggests using proton pump inhibition over no treatment. […] 2. In patients with eosinophilic esophagitis (EoE), AGA/JTF recommends topical glucocorticosteroids over no treatment. […] 3. In patients with EoE, AGA/JTF suggests topical glucocorticosteroids rather than oral glucocorticosteroids. […] 4. In patients with EoE, AGA/JTF suggests using elemental diet over no treatment. […] 5. In patients with EoE, AGA/JTF suggests using an empiric, six-food elimination diet over no treatment. […] 6. In patients with EoE, AGA/JTF suggests using an allergy testing-based elimination diet over no treatment. […] 7. In patient with EoE in remission after short-term use of topical glucocorticosteroids, AGA/JTF suggests continuation of topical glucocorticosteroids over discontinuation of treatment.

• #28 Management of eosinophilic esophagitis (EoE) – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/management-of-eosinophilic-esophagitis-eoe/

  8. In adult patients with dysphagia from a stricture associated with EoE, AGA/JTF suggests endoscopic dilation over no dilation. […] 9. In patients with EoE, AGA/JTF recommends using anti–IL-5 therapy for EoE only in the context of a clinical trial. […] 10. In patients with EoE, AGA/JTF recommends using anti-IL-13 or anti-IL-4 receptor α therapy for EoE only in the context of a clinical trial. […] 11. In patients with EoE, AGA/JTF suggests against the use of anti-IgE therapy for EoE. […] 12. In patients with EoE, AGA/JTF suggest using montelukast, cromolyn sodium, immunomodulators, and anti-TNF for EoE only in the context of a clinical trial.

• #29 Management of Eosinophilic Esophagitis

  https://www.aap.org/en/patient-care/eosinophilic-esophagitis/management-of-eosinophilic-esophagitis/?srsltid=AfmBOootEBqpYDWF7xWQAbMJXUNqDxWPSXDmCIpQWp1CIpkqU0LJRlde

  EoE is a chronic disease that requires long-term treatment. The goals of treatment are to: […] Prevent disease complications (malnutrition, suboptimal growth)). […] Treating children with EoE involves diet therapy and/or medical therapy. […] A multi-center, retrospective study drawing from a European database of patients with EoE (adults and children) demonstrated that clinical and histologic remission or response occurred in 82% of patients taking topical steroids, 69% of patients taking proton pump inhibitors, and 42% of patients on empirical elimination diets. […] Recent guidelines promote shared decision making and individualized approaches towards management. […] For many children, EoE is a non-IgE-mediated allergic disease, thus removal of relevant food allergens can cause remission of the disease.

• #30 Management of Eosinophilic Esophagitis

  https://www.aap.org/en/patient-care/eosinophilic-esophagitis/management-of-eosinophilic-esophagitis/?srsltid=AfmBOootEBqpYDWF7xWQAbMJXUNqDxWPSXDmCIpQWp1CIpkqU0LJRlde

  Dietary restrictions are well known to reduce quality of life; however, a multidisciplinary approach available in an EoE clinic can anticipate and address these aspects. […] In consensus guidelines, the failure to respond to PPIs has been removed as a criterion for ruling out a diagnosis of EoE because some patients with EoE improve with PPI therapy. […] PPIs may be considered first-line therapy for EoE, before elimination diets are recommended and before topical steroids are considered. […] Swallowed topical glucocorticoids taken in a small amount of liquid or a puff from an inhaler are the mainstay treatment option to medically treat inflammation; remission rates are high with this method. […] Dupilumab, a monoclonal antibody to IL-4 receptor alpha, is the first biologic treatment for EoE approved by the FDA. […] When dietary or anti-inflammatory treatment are ineffective, children with EoE may develop esophageal strictures or stenosis. […] In some children, esophageal dilation may be necessary to prevent food impaction and pain.

• #31 Eosinophilic Esophagitis | Sean N. Parker Center for Allergy and Asthma Research | Stanford Medicine

  https://med.stanford.edu/allergyandasthma/news/news-from-our-center/eosinophilic-esophagitis.html

  Dietary therapy is typically initiated with an elimination diet to identify and then eliminate the food trigger(s) […] While the majority of patients respond positively to dietary therapy, it is far from optimalparticularly in growing children. Topical corticosteroids appear to be safe when limited to the duration of treatment (usually 6-8 weeks). But the reported rate of symptom recurrence following treatment cessation is high, and patients are reluctant to use pharmacologic therapy on a long-term basis, which is most likely necessary. That these are two of the few treatment options available to EoE patients, points to the immense need for further research to develop better therapeutic options.

• #32 Medications for Eosinophilic Esophagitis

  https://www.webmd.com/digestive-disorders/eoe-medications

  While theres no cure for eosinophilic esophagitis (EoE), there are several medications doctors prescribe to control symptoms, ease inflammation, and prevent further damage. […] Most patients respond well to this treatment. […] While all of these drugs work, you need to take them every day to see benefits. Once you stop, your symptoms will come back. Your doctor may put you on a lower dose for maintenance. […] It led to a significant reduction in common EoE symptoms like trouble swallowing.

• #33 Management of Eosinophilic Esophagitis

  https://www.aap.org/en/patient-care/eosinophilic-esophagitis/management-of-eosinophilic-esophagitis/?srsltid=AfmBOootEBqpYDWF7xWQAbMJXUNqDxWPSXDmCIpQWp1CIpkqU0LJRlde

  Dietary restrictions are well known to reduce quality of life; however, a multidisciplinary approach available in an EoE clinic can anticipate and address these aspects. […] In consensus guidelines, the failure to respond to PPIs has been removed as a criterion for ruling out a diagnosis of EoE because some patients with EoE improve with PPI therapy. […] PPIs may be considered first-line therapy for EoE, before elimination diets are recommended and before topical steroids are considered. […] Swallowed topical glucocorticoids taken in a small amount of liquid or a puff from an inhaler are the mainstay treatment option to medically treat inflammation; remission rates are high with this method. […] Dupilumab, a monoclonal antibody to IL-4 receptor alpha, is the first biologic treatment for EoE approved by the FDA. […] When dietary or anti-inflammatory treatment are ineffective, children with EoE may develop esophageal strictures or stenosis. […] In some children, esophageal dilation may be necessary to prevent food impaction and pain.

• #34 Medications for Eosinophilic Esophagitis

  https://www.webmd.com/digestive-disorders/eoe-medications

  While theres no cure for eosinophilic esophagitis (EoE), there are several medications doctors prescribe to control symptoms, ease inflammation, and prevent further damage. […] Most patients respond well to this treatment. […] While all of these drugs work, you need to take them every day to see benefits. Once you stop, your symptoms will come back. Your doctor may put you on a lower dose for maintenance. […] It led to a significant reduction in common EoE symptoms like trouble swallowing.

• #35 Treatment Options for Patients with Eosinophilic Esophagitislogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na55648/2023/01/03/treatment-options-patients-with-eosinophilic-esophagitis

  For my patients with EoE, I begin with high-dose proton-pump inhibitors, which can provide histological and clinical remission in 50% to 60% of patients. I then offer the option of an elimination diet. Based on this study, avoiding milk and wheat (and possibly soy and egg) seems appropriate for adults initially, followed by 6FED for those who do not respond. […] If food avoidance is not effective or feasible, I use swallowed fluticasone with a metered dose inhaler or swallowed budesonide mixed in Splenda or honey (≈85% of children and ≈65% of adults respond to swallowed steroids). […] For patients who don’t respond to swallowed steroids and elimination diets, dupilumab is the only current U.S. FDA-approved agent — dupilumab is even more attractive if the patient has concomitant severe eczema or asthma.

• #36 Management of eosinophilic esophagitis (EoE) – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/management-of-eosinophilic-esophagitis-eoe/

  8. In adult patients with dysphagia from a stricture associated with EoE, AGA/JTF suggests endoscopic dilation over no dilation. […] 9. In patients with EoE, AGA/JTF recommends using anti–IL-5 therapy for EoE only in the context of a clinical trial. […] 10. In patients with EoE, AGA/JTF recommends using anti-IL-13 or anti-IL-4 receptor α therapy for EoE only in the context of a clinical trial. […] 11. In patients with EoE, AGA/JTF suggests against the use of anti-IgE therapy for EoE. […] 12. In patients with EoE, AGA/JTF suggest using montelukast, cromolyn sodium, immunomodulators, and anti-TNF for EoE only in the context of a clinical trial.

• #37 Management of eosinophilic esophagitis (EoE) – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/management-of-eosinophilic-esophagitis-eoe/

  8. In adult patients with dysphagia from a stricture associated with EoE, AGA/JTF suggests endoscopic dilation over no dilation. […] 9. In patients with EoE, AGA/JTF recommends using anti–IL-5 therapy for EoE only in the context of a clinical trial. […] 10. In patients with EoE, AGA/JTF recommends using anti-IL-13 or anti-IL-4 receptor α therapy for EoE only in the context of a clinical trial. […] 11. In patients with EoE, AGA/JTF suggests against the use of anti-IgE therapy for EoE. […] 12. In patients with EoE, AGA/JTF suggest using montelukast, cromolyn sodium, immunomodulators, and anti-TNF for EoE only in the context of a clinical trial.

• #38 Eosinophilic Esophagitis: Causes, Treatment, and Diet

  https://www.healthline.com/health/eosinophilic-esophagitis

  The best way to prevent food impactions is to see a doctor regularly, even if you feel well, and for urgent follow-ups if your EoE symptoms are flaring. You should also follow their guidance for managing EoE. […] Because eosinophilic esophagitis could be caused or worsened by an allergic response to certain foods, your treatment may include eliminating those foods from your diet. […] If you have a known food allergy based on pinprick testing, your doctor will most likely start by recommending that you eliminate that food right away. […] In an elimination diet, you would completely remove all these foods from your diet and then slowly reintroduce them one by one to determine whether you’re sensitive to any of them. […] However, dilation is done on an as-needed basis when eosinophilic esophagitis gets serious enough to cause narrowing of the esophagus and make swallowing difficult. This procedure does not prevent the buildup of eosinophils. It just relieves the constriction long enough to hopefully allow other remedies to prevent the condition from progressing.

• #39 Management of Eosinophilic Esophagitis

  https://www.aap.org/en/patient-care/eosinophilic-esophagitis/management-of-eosinophilic-esophagitis/?srsltid=AfmBOootEBqpYDWF7xWQAbMJXUNqDxWPSXDmCIpQWp1CIpkqU0LJRlde

  Dietary restrictions are well known to reduce quality of life; however, a multidisciplinary approach available in an EoE clinic can anticipate and address these aspects. […] In consensus guidelines, the failure to respond to PPIs has been removed as a criterion for ruling out a diagnosis of EoE because some patients with EoE improve with PPI therapy. […] PPIs may be considered first-line therapy for EoE, before elimination diets are recommended and before topical steroids are considered. […] Swallowed topical glucocorticoids taken in a small amount of liquid or a puff from an inhaler are the mainstay treatment option to medically treat inflammation; remission rates are high with this method. […] Dupilumab, a monoclonal antibody to IL-4 receptor alpha, is the first biologic treatment for EoE approved by the FDA. […] When dietary or anti-inflammatory treatment are ineffective, children with EoE may develop esophageal strictures or stenosis. […] In some children, esophageal dilation may be necessary to prevent food impaction and pain.

• #40 Eosinophilic Esophagitis: Causes, Treatment, and Diet

  https://www.healthline.com/health/eosinophilic-esophagitis

  The best way to prevent food impactions is to see a doctor regularly, even if you feel well, and for urgent follow-ups if your EoE symptoms are flaring. You should also follow their guidance for managing EoE. […] Because eosinophilic esophagitis could be caused or worsened by an allergic response to certain foods, your treatment may include eliminating those foods from your diet. […] If you have a known food allergy based on pinprick testing, your doctor will most likely start by recommending that you eliminate that food right away. […] In an elimination diet, you would completely remove all these foods from your diet and then slowly reintroduce them one by one to determine whether you’re sensitive to any of them. […] However, dilation is done on an as-needed basis when eosinophilic esophagitis gets serious enough to cause narrowing of the esophagus and make swallowing difficult. This procedure does not prevent the buildup of eosinophils. It just relieves the constriction long enough to hopefully allow other remedies to prevent the condition from progressing.

• #41 Eosinophilic Esophagitis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/digestion-and-metabolic-health/eosinophilic-esophagitis.html

  Eosinophilic esophagitis (EoE) occurs when an unusually high number of a certain type of white blood cells, called eosinophils, respond to an allergic-like reaction in your esophagus. […] At Stanford, we plan a minimally invasive approach to treatment to help you recover faster and avoid certain complications. […] Our nutritionists work with you to find dietary changes, including avoiding trigger foods, that may help manage symptoms of EoE without other forms of treatment. […] If dietary changes alone do not work, certain medications may help prevent symptoms. […] Because of the nature of EoE, the Esophagus Center doctors closely collaborate with specialists in immunology and nutrition. Working together, we find the best, least invasive treatment solutions for you, so you can lead a symptom-free, healthier life.

• #42 Management of Eosinophilic Esophagitis

  https://www.aap.org/en/patient-care/eosinophilic-esophagitis/management-of-eosinophilic-esophagitis/?srsltid=AfmBOootEBqpYDWF7xWQAbMJXUNqDxWPSXDmCIpQWp1CIpkqU0LJRlde

  EoE is a chronic disease that requires long-term treatment. The goals of treatment are to: […] Prevent disease complications (malnutrition, suboptimal growth)). […] Treating children with EoE involves diet therapy and/or medical therapy. […] A multi-center, retrospective study drawing from a European database of patients with EoE (adults and children) demonstrated that clinical and histologic remission or response occurred in 82% of patients taking topical steroids, 69% of patients taking proton pump inhibitors, and 42% of patients on empirical elimination diets. […] Recent guidelines promote shared decision making and individualized approaches towards management. […] For many children, EoE is a non-IgE-mediated allergic disease, thus removal of relevant food allergens can cause remission of the disease.

• #43 Eosinophilic Esophagitis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/digestion-and-metabolic-health/eosinophilic-esophagitis.html

  Eosinophilic esophagitis (EoE) occurs when an unusually high number of a certain type of white blood cells, called eosinophils, respond to an allergic-like reaction in your esophagus. […] At Stanford, we plan a minimally invasive approach to treatment to help you recover faster and avoid certain complications. […] Our nutritionists work with you to find dietary changes, including avoiding trigger foods, that may help manage symptoms of EoE without other forms of treatment. […] If dietary changes alone do not work, certain medications may help prevent symptoms. […] Because of the nature of EoE, the Esophagus Center doctors closely collaborate with specialists in immunology and nutrition. Working together, we find the best, least invasive treatment solutions for you, so you can lead a symptom-free, healthier life.

• #44 Disease Resolution after Cessation of Treatment in Patients with Eosinophilic Esophagitis

  https://www.scientificarchives.com/article/disease-resolution-after-cessation-of-treatment-in-patients-with-eosinophilic-esophagitis

  EoE is a chronic condition that frequently recurs in patient who discontinues treatment. It is generally necessary to continue maintenance treatment, whether avoidance of dietary triggers or pharmacological, to maintain remission. […] Treatment-free EoE remission is one of research focuses. It has been postulated that if it appears that a patient with EoE is likely to undergo spontaneous remission or experience minor consequences, the risks of long-term therapy may outweigh the benefits. […] Large scale prospective study is needed to further definitively evaluate the rate of treatment-free disease resolution in EoE patients. This will undoubtedly have a significant impact on managing EoE patients, to potentially avoid long-term pharmacological treatment or diet elimination.

• #45 Disease Resolution after Cessation of Treatment in Patients with Eosinophilic Esophagitis

  https://www.scientificarchives.com/article/disease-resolution-after-cessation-of-treatment-in-patients-with-eosinophilic-esophagitis

  EoE is a chronic condition that frequently recurs in patient who discontinues treatment. It is generally necessary to continue maintenance treatment, whether avoidance of dietary triggers or pharmacological, to maintain remission. […] Treatment-free EoE remission is one of research focuses. It has been postulated that if it appears that a patient with EoE is likely to undergo spontaneous remission or experience minor consequences, the risks of long-term therapy may outweigh the benefits. […] Large scale prospective study is needed to further definitively evaluate the rate of treatment-free disease resolution in EoE patients. This will undoubtedly have a significant impact on managing EoE patients, to potentially avoid long-term pharmacological treatment or diet elimination.

• #46 Disease Resolution after Cessation of Treatment in Patients with Eosinophilic Esophagitis

  https://www.scientificarchives.com/article/disease-resolution-after-cessation-of-treatment-in-patients-with-eosinophilic-esophagitis

  EoE is a chronic condition that frequently recurs in patient who discontinues treatment. It is generally necessary to continue maintenance treatment, whether avoidance of dietary triggers or pharmacological, to maintain remission. […] Treatment-free EoE remission is one of research focuses. It has been postulated that if it appears that a patient with EoE is likely to undergo spontaneous remission or experience minor consequences, the risks of long-term therapy may outweigh the benefits. […] Large scale prospective study is needed to further definitively evaluate the rate of treatment-free disease resolution in EoE patients. This will undoubtedly have a significant impact on managing EoE patients, to potentially avoid long-term pharmacological treatment or diet elimination.

• #47 Eosinophilic Esophagitis | Sean N. Parker Center for Allergy and Asthma Research | Stanford Medicine

  https://med.stanford.edu/allergyandasthma/news/news-from-our-center/eosinophilic-esophagitis.html

  Dietary therapy is typically initiated with an elimination diet to identify and then eliminate the food trigger(s) […] While the majority of patients respond positively to dietary therapy, it is far from optimalparticularly in growing children. Topical corticosteroids appear to be safe when limited to the duration of treatment (usually 6-8 weeks). But the reported rate of symptom recurrence following treatment cessation is high, and patients are reluctant to use pharmacologic therapy on a long-term basis, which is most likely necessary. That these are two of the few treatment options available to EoE patients, points to the immense need for further research to develop better therapeutic options.

• #48 Spreading eosinophilic esophagitis awareness and wellness in patients – Bristol Myers Squibb

  https://www.bms.com/life-and-science/science/spreading-eosinophilic-esophagitis-awareness-and-wellness-in-patients.html

  Addressing the underlying inflammation and fibrosis and doing so early in the course of the disease is key to preventing serious complications and improving how patients feel. […] We are dedicated to making a meaningful impact on EoE treatment by working to advance patient care.

• #49 Eosinophilic Esophagitis: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/digestive/esophageal-diseases/eosinophilic-esophagitis/treatment

  Eosinophilic esophagitis is a lifelong disease whose symptoms can come and go. It is helpful to learn the triggers of your symptoms so you can avoid them. […] The most effective therapies to reduce or prevent symptoms include dietary changes, medications, and when needed, dilation of the esophagus if it becomes constricted.

• #50 What can help treat eosinophilic esophagitis?

  https://www.medicalnewstoday.com/articles/eosinophilic-esophagitis-treatment

  Eosinophilic esophagitis treatment aims to decrease symptoms, prevent damage to the esophagus, and improve quality of life. […] In many people, an abnormal immune reaction to certain foods is the main cause of eosinophilic esophagitis. This is why a healthcare professional may recommend an elimination diet. […] An individual stops eating the foods listed above for several weeks. After a few weeks, they add foods back one by one to determine what food triggered the allergic reaction. […] The formula replacement may continue for 6 weeks to allow the esophagus to heal. Foods less likely to cause an allergic response are then gradually reintroduced. […] Treatment aims to stop inflammation, reduce symptoms, and improve swallowing. Treatment options may include elimination diets to determine the food trigger. Doctors may also prescribe medications, such as corticosteroids, proton pump inhibitors, or Dupilumab, to help reduce inflammation.

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