Materiały źródłowe

• #1 Esophagitis: What It Is, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10138-esophagitis

  Esophagitis is treatable, but severe esophagitis that goes untreated can lead to serious complications, such as: […] Esophagitis will heal if you can stop whats irritating your esophagus long enough to let the natural healing process continue. This may require various lifestyle changes or medications, depending on the cause. Medications can also help to protect and promote healing in your esophagus. […] Treatment typically includes medication and lifestyle changes. […] Medications may include: […] Acid-blocking medication. Antacids, H2 blockers and proton-pump inhibitors (PPIs) can help treat acid reflux. There are over-the-counter (OTC) and prescription-strength options. […] Anti-inflammatory drugs. For eosinophilic esophagitis, healthcare providers sometimes recommend swallowing a liquid steroid formula. The formula coats your esophagus and relieves inflammation without causing the same side effects that you may get from the pill form.

• #1 Esophagitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/esophagitis/diagnosis-treatment/drc-20361264

  Treatments for esophagitis are intended to lessen symptoms, manage complications and treat the causes of the condition. Treatment methods vary based on the cause of esophagitis. […] Treatment for reflux esophagitis may include: […] Medicines available without a prescription. These include antacids (Maalox, Mylanta, others); medicines called H-2-receptor blockers that lower stomach acid, such as cimetidine (Tagamet HB); and medicines called proton pump inhibitors that block stomach acid and heal the esophagus, such as lansoprazole (Prevacid 24 HR) and omeprazole (Prilosec OTC), among others. […] Prescription medicines. These include prescription-strength H-2-receptor blockers and proton pump inhibitors. […] Surgery. A type of surgery called fundoplication may improve the condition of the esophagus if other treatments don’t work. The surgeon wraps a portion of the stomach around the valve that separates the esophagus and stomach. This valve is called the lower esophageal sphincter. This surgery can strengthen the sphincter and prevent acid from backing up into the esophagus.

• #2 Esophagitis | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/esophagitis

  Treatment for esophagitis depends on its exact cause and how badly the tissue that lines the esophagus is damaged. Without treatment, esophagitis can damage this lining. The esophagus may start to have trouble moving food and liquid from the mouth to the stomach. Esophagitis also can lead to other serious health issues. These include scarring or narrowing of the esophagus, unhealthy weight loss, and dehydration. […] Treatments for esophagitis are intended to lessen symptoms, manage complications and treat the causes of the condition. Treatment methods vary based on the cause of esophagitis. […] Treatment for reflux esophagitis may include: Medicines available without a prescription. These include antacids (Maalox, Mylanta, others); medicines called H-2-receptor blockers that lower stomach acid, such as cimetidine (Tagamet HB); and medicines called proton pump inhibitors that block stomach acid and heal the esophagus, such as lansoprazole (Prevacid 24 HR) and omeprazole (Prilosec OTC), among others.

• #3 Esophagitis

  https://www.rwjbh.org/treatment-care/surgery/thoracic-surgery/thoracic-diseases-and-conditions/esophagitis/

  Antacids will help relieve heartburn or indigestion caused by excess stomach acid. […] H2 receptors will help reduce the amount of acid production. […] Proton pump inhibitors will help block acid production and heal the esophagus. […] Prokinetics will help your stomach empty more quickly. […] Medications for Eosinophilic Esophagitis […] Proton pump inhibitors will relieve symptoms of acid reflux, or gastroesophageal reflux disease. […] Topical steroids will help reduce the inflammation within the esophagus. […] Medications for Drug-Induced Esophagitis […] Treatment for drug-induced esophagitis is primarily avoiding the problem drug when possible and reducing the risk with better pill-taking habits. […] Your doctor may recommend: […] Taking an alternative drug. […] Taking a liquid version of a medication if possible. […] Drinking an entire glass of water with a pill, unless you’ve been told by your doctor to restrict your fluid intake. […] Sitting or standing for at least 30 minutes after taking a pill. […] Medical and Surgical Procedures […] Fundoplication.

• #4 Esophagitis Treatment & Management: Approach Considerations, Reflux Esophagitis, Infectious Esophagitis

  https://emedicine.medscape.com/article/174223-treatment

  Previously, histamine-2 receptor antagonist (H2RA) therapy was recommended as the initial treatment for esophagitis associated with gastroesophageal reflux disease (GERD); however, subsequent studies of cost-effectiveness and symptomatic relief suggested that proton pump inhibitors (PPIs) (eg, omeprazole 20 mg/day, pantoprazole 40 mg/day, or lansoprazole 30 mg/day for 4-8 weeks) are superior to ranitidine, cimetidine, and placebo. […] PPIs are recommended over H2-receptor antagonists for healing and maintenance of erosive esophagitis. […] The 2022 GERD guidelines from ACG recommend an 8-week trial of empiric PPI in patients with classic GERD symptoms who have no alarm symptoms. […] According to the 2022 ACG guidelines, GERD patients whose symptoms continue after discontinuance of PPI therapy and those with complications such as erosive esophagitis and Barrett esophagus are likely to require long-term, even life-long, maintenance therapy.

• #5 Esophagitis Treatment & Management: Approach Considerations, Reflux Esophagitis, Infectious Esophagitis

  https://emedicine.medscape.com/article/174223-treatment

  The FDA approved vonoprazan (Voquezna), a potassium-competitive acid blocker, in 2023 for treatment and maintenance of erosive esophagitis. […] Medical therapy for fungal conditions falls into the following three categories: Topically active agents include nystatin, clotrimazole, and oral amphotericin B; Orally administered absorbable agents include fluconazole and itraconazole; Parenterally administered agents include amphotericin B, fluconazole, and flucytosine. […] Treatment of nonreflux, noninfectious esophagitis depends on the underlying conditions. […] The treatment of eosinophilic esophagitis continues to evolve. Various interventions, such as complete avoidance of precipitating food allergens, esophageal dilatation, corticosteroids, cromolyn sodium, and leukotriene inhibitors, have been employed.

• #6 Medical or Surgical Therapy for Erosive Reflux Esophagitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1422565/

  Before the advent of potent antisecretory drugs, surgery was a keystone in the long-term management of GERD. […] Since 1991, the laparoscopic Nissen fundoplication (LNF) has shown physiologic results similar to those of the open technique. […] For those individuals requiring long-term maintenance therapy for GERD, LNF is becoming an increasingly viable option, with the perceived advantages of decreased cost and avoidance of long-term drug side effects. […] Our analysis illustrates that LNF is a cost-effective option for middle-aged patients with erosive esophagitis when the expected time of medical maintenance therapy is more than 3.1 years.

• #7 Esophagitis: Causes, Symptoms, & Treatments

  https://www.webmd.com/digestive-disorders/esophagitis

  Esophagitis Treatments […] Treatment of esophagitis depends on the type you have. […] Reflux esophagitis […] To treat this, you might use: […] Over-the-counter drugs like antacids or medications that block acid production like lansoprazole (Prevacid) and omeprazole (Prilosec) […] Prescription drugs that can block acid production or help clear your stomach […] Surgery to strengthen the valve that separates your stomach and esophagus […] Surgery to put a ring of metal beads around the lower part of your esophagus. This fairly new process is called a LINX procedure. The beads make your esophagus stronger, so acid can’t back up. […] Eosinophilic esophagitis […] To treat this, you might take: […] Prescription medicines to block acid production […] Steroids like budesonide (Pulmicort) and fluticasone (Flovent) that you swallow in liquid form; you may have fewer side effects than if you take steroids as a pill […] Monoclonal antibodies like dupilumab (Dupixent) work by stopping the action of inflammation-causing proteins; you get it in a weekly injection.

• #8 Esophagitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/esophagitis/diagnosis-treatment/drc-20361264

  Treatment for eosinophilic esophagitis involves staying away from the allergen that trigger symptoms. Treatment also involves easing the allergic reaction with medicines. […] Your healthcare professional likely will first prescribe a proton pump inhibitor. You might take one such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec) or pantoprazole (Protonix). […] Some studies show that swallowed steroids may act on the surface tissue of the esophagus to treat eosinophilic esophagitis. One steroid called budesonide (Eohilia) comes in a liquid form. Another steroid called fluticasone is sprayed into the mouth and then swallowed. […] Treatment for medicine-induced esophagitis involves not using the problem medicine when possible. It also involves lowering the risk of this condition with proper pill-taking habits.

• #9 Treatment for Eosinophilic Esophagitis in Children | GI Care for Kids

  https://www.gicareforkids.com/conditions-we-treat/eosinophilic-esophagitis/

  Proton pump inhibitor therapy (omeprazole, lansoprazole, or esomeprazole, among others) includes medications traditionally used for acid reflux. However, these medications also have anti-inflammatory qualities and have been shown to be effective in up to 50% of patients with EoE. […] Dietary therapy includes elimination of certain foods that commonly trigger EoE. The most common food triggers include milk, soy, egg, and wheat. Your doctor may initially recommend excluding all four of these foods or may recommend eliminating one or two at a time. These customized, empirical diets have been shown to be effective in up to 70% of children with EoE. […] In children with severe and unresponsive EoE, another dietary approach is the elemental diet, where all sources of intact proteins are eliminated, and patients are supported with a fully broken-down (“elemental”) formula. While these dietary changes can be difficult to maintain, this therapy has been shown to be effective in nearly 100% of children with EoE. […] Regardless of the type of dietary therapy, however, the ultimate goal is to find the specific foods that are triggering the inflammation, which will allow your child to have the least restrictive diet possible.

• #10 Treatment for Eosinophilic Esophagitis in Children | GI Care for Kids

  https://www.gicareforkids.com/conditions-we-treat/eosinophilic-esophagitis/

  How is EoE Treated? There are a variety of methods used to treat EoE, including the below. You and your child’s doctor will determine which treatment is best for your child. In rare cases, dilation therapy to stretch the esophagus may be required. […] Topical corticosteroid therapy includes taking anti-inflammatory medications often used to control inflammation associated with asthma (budesonide or fluticasone). While these medications are considered steroids, when given topically, they do not have the same side effects as traditional steroids. When swallowed, these medications coat the esophagus, reducing swelling. Studies have shown that topical corticosteroid therapy can induce remission in up to 80% of EoE patients. The ultimate goal is to find the lowest possible dose and frequency that will maintain remission.

• #11 Esophagitis Medication: Proton Pump Inhibitors, Potassium-Competitive Acid Blockers, Histamine-2 Receptor Antagonists, Gastrointestinal Protective Agents, Antifungal Agents, Antiviral Agents, Corticosteroids, Leukotriene Inhibitors, Mast Cell Stabilizers,

  https://emedicine.medscape.com/article/174223-medication

  Medications used to treat esophagitis vary depending on the etiology. Treatment goals for reflux esophagitis include pain relief, decreased acid production, decreased acid reflux, and protection of the esophageal mucosa. Multiple pharmacologic agents are available, including proton pump inhibitors (PPIs), potassium-competitive acid blockers (PCABs), histamine-2 receptor antagonists (H2RAs), gastroprokinetic agents, and protective agents. […] Therapy for infectious esophagitis is directed at the underlying condition, with the goal of minimizing symptoms and preventing complications. The choice of the therapeutic agent depends on the severity of infection and the degree of host defense impairment. […] The FDA approved dupilumab for treatment of eosinophilic esophagitis in adults and children aged 1 year and older who weigh at least 15 kg. […] Vonoprazan is indicated for treatment and maintenance of healing of all grades of erosive esophagitis. […] Dupilumab is indicated for treatment of eosinophilic esophagitis in adults and children aged 1 year and older who weigh at least 15 kg.

• #12 Esophagitis: What It Is, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10138-esophagitis

  Antifungal medication for fungal infections, such as candida. […] Antiviral medication for viral infections, such as herpes. […] Monoclonal antibodies. These are synthetic versions of proteins that communicate with your immune system to stop inflammation. Dupilumab is a monoclonal antibody medication thats been recently approved by the U.S. Food and Drug Administration to treat eosinophilic esophagitis. […] Lifestyle recommendations may include: […] Dietary changes. Identify the foods and drinks that trigger acid indigestion and reflux or that trigger an allergic reaction. […] Medication changes. Ask your provider about switching medications that cause esophagitis, or consider switching to a liquid form. If you have to take a pill, take it with a full glass of water. […] Evening routine. To reduce acid reflux, eat smaller meals, especially at dinner time. Make sure dinner is at least three hours before bedtime to give it a chance to digest before you lie down.

• #13 Eosinophilic Esophagitis | Symptoms & Treatment | ACAAI Public Website

  https://acaai.org/allergies/allergic-conditions/eosinophilic-esophagitis/

  Eosinophilic Esophagitis (known as EoE) is a disorder of the esophagus, the tube that connects your mouth to your stomach. […] Although there is no cure, treatment is available. […] Your doctor can help you find a treatment plan that works for you. The treatment prescribed will depend on what’s triggering your EoE and the severity of your symptoms. Treatments may include: Topical steroids: Topical steroids can be liquid medication you swallow, such as budesonide or inhaled and swallowed, such as fluticasone. […] Proton pump inhibitors (PPI): PPIs are oral medications that reduce the acid in your stomach. […] Diet therapy: The allergist may recommend you eliminate all foods that are common triggers of EoE, including tree nuts, peanuts, fish and shellfish, wheat, dairy products, eggs and soy products.

• #14 Management of Eosinophilic Esophagitis

  https://www.aap.org/en/patient-care/eosinophilic-esophagitis/management-of-eosinophilic-esophagitis/?srsltid=AfmBOop6–jpExkJzCfEVGWUvUG6HDDonU4EhR3ZENMdTOBiIHf2ldsz

  A six-food elimination diet (SFED) has been shown to cause a histologic remission rate of approximately 73% in children. […] The overall effectiveness of empirical milk-only elimination diets has been reported to be 68% in one small study (n = 17). […] 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.

• #14 Management of Eosinophilic Esophagitis

  https://www.aap.org/en/patient-care/eosinophilic-esophagitis/management-of-eosinophilic-esophagitis/?srsltid=AfmBOop6–jpExkJzCfEVGWUvUG6HDDonU4EhR3ZENMdTOBiIHf2ldsz

  EoE is a chronic disease that requires long-term treatment. The goals of treatment are to: […] 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. […] The choice of treatment depends on the clinical picture, as well as family circumstance and preferences. […] Recent guidelines promote shared decision making and individualized approaches towards management. […] Dietary therapy has 3 main approaches: […] The elemental diet is a highly restrictive diet that consists of a liquid amino acid-based formula, which does not induce an allergic response. It has been shown to be more than 90% effective in causing histological remission of EoE symptoms.

• #15

  https://www.eosnetwork.org/eoe-treatment

  Sometimes, the first dietary approach patients adopt is to avoid the types of food that stick. […] The common foods linked to the condition which might be excluded include: dairy, wheat, eggs, soya, rice, some fish and some vegetables (legumes). […] A recent study has found eliminating just animal milk from the diet of adults with EoE is as effective as the traditional 6FED (6 Food Elimination) diet therapy of eliminating six food groups, including animal milk, wheat, egg, soya, fish/shellfish and peanut/tree nuts. […] During this process, careful attention to nutrition with the help of a dietitian with expertise in EoE is essential to support a structured food exclusion and reintroduction and reassessment plan. […] Dilatation is an endoscopic procedure usually performed under sedation. In it, a narrowing (oesophageal stricture) is stretched to widen the oesophagus and allow food to pass through more comfortably. […] It can be needed if the drugs/management is ineffective and would need to be complemented with a continuation of either a diet or drugs as above.

• #16 Esophagitis | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/esophagitis

  Treatment for eosinophilic esophagitis involves staying away from the allergen that trigger symptoms. Treatment also involves easing the allergic reaction with medicines. […] Treatment for medicine-induced esophagitis involves not using the problem medicine when possible. It also involves lowering the risk of this condition with proper pill-taking habits. […] Your healthcare professional may prescribe medicine to treat an infection that causes infectious esophagitis. Medicines can help clear up infections from viruses, bacteria or fungi. […] A doctor called a gastroenterologist who treats digestive conditions may use medical tools to expand the esophagus. This treatment is called esophageal dilation. It tends to be used only if the esophagus becomes very narrow or if food becomes stuck in the esophagus.

• #17 Esophagitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/esophagitis/diagnosis-treatment/drc-20361264

  Your healthcare professional may prescribe medicine to treat an infection that causes infectious esophagitis. Medicines can help clear up infections from viruses, bacteria or fungi. […] A doctor called a gastroenterologist who treats digestive conditions may use medical tools to expand the esophagus. This treatment is called esophageal dilation. It tends to be used only if the esophagus becomes very narrow or if food becomes stuck in the esophagus.

• #18 Esophagitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK442012/

  For eosinophilic esophagitis treatment include acid suppression, topical or systemic steroids either topical budesonide or fluticasone and dietary modification if a food allergy is suspected. […] If etiology is infectious, target therapy is indicated. For C. Albicans, oral fluconazole is the drug of choice. For HSV esophagitis, treatment is oral or intravenous acyclovir and Foscarnet for those who are non-responders. CMV esophagitis is treated with Gancyclovir or Valganciclovir. […] Treatment of complications like stenosis or stricture may require endoscopic dilation. Addition of topical anesthesia like topical lidocaine (e.g. GI cocktail) and opioids may help in ulcers related pain. NSAIDs must be avoided as it may exacerbate symptoms.

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

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

  Topical steroids are more effective than proton pump inhibitors, resolving inflammation in two-thirds of patients, more than four times the placebo response. […] Dysphagia in eosinophilic esophagitis is primarily caused by strictures secondary to inflammation. Endoscopic dilation leads to symptom improvement in 87% of patients.

• #20 Esophagitis

  https://www.rwjbh.org/treatment-care/surgery/thoracic-surgery/thoracic-diseases-and-conditions/esophagitis/

  Treatment of Esophagitis […] Treatments for esophagitis are intended to lessen symptoms, manage complications and treat underlying causes of the disorder. Treatment strategies vary primarily based on the cause of the disorder. Some treatment options include: […] Lifestyle Changes (Applicable to All Types of Esophagitis) […] Avoid smoking. […] If you’re overweight, talk to your doctor about weight loss options. […] Avoid foods that may increase reflux such as alcohol, caffeine, chocolate and mint-flavored foods. […] Avoid certain medications such as pain relievers and antibiotics. […] Avoid stooping or bending, especially soon after eating. […] Avoid lying down after eating. […] Make and keep appointments to see your doctor for routine check-ups and follow-up tests. […] Medications for Reflux Esophagitis

• #21 Esophagitis: What It Is, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10138-esophagitis

  Commonsense self-care. Quit smoking and avoid alcohol to protect your esophagus. […] If youre confident that the injury that caused it has stopped, your esophagitis may be able to heal on its own after several weeks. But its a good idea to get a medical evaluation and opinion. A healthcare provider can confirm the cause of your esophagitis and advise you on treating that particular cause. […] Some persistent cases may take some trial and error with different medications before landing on the right treatment. Once the right treatment begins, healing usually begins immediately. But it may take three to six weeks for esophagitis to heal completely. If the cause is a chronic condition, you may need long-term therapy to manage it.

• #22 Medical or Surgical Therapy for Erosive Reflux Esophagitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1422565/

  Medical therapy with proton pump inhibitors for endoscopically proven reflux esophagitis is a safe and effective treatment option. […] The authors found that 20 mg/day omeprazole would have to cost less than $38.60 per month before medical therapy became cost effective; conversely, the cost of LNF would have to be more than $5,273.70 or the length of stay more than 4.2 days for medical therapy to be cost effective. […] For patients with severe esophagitis, LNF is a cost-effective alternative to long-term maintenance therapy with proton pump inhibitors. […] The most frustrating aspect of GERD treatment is the high relapse rate after successful medical healing. More than 80% of patients with erosive (grade II or higher) esophagitis will relapse within 6 months, with 50% of the relapses occurring in the first month.

• #23 Eosinophilic esophagitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/eosinophilic-esophagitis/diagnosis-treatment/drc-20372203

  Eosinophilic esophagitis is considered a chronic relapsing disease, meaning that most people will require ongoing treatment to control their symptoms. Treatment will involve one or more of the following: […] Depending on your response to tests for food allergies, your health care provider may recommend that you stop eating certain foods. Cutting out some foods, such as dairy or wheat products, may help to relieve symptoms and reduce inflammation. Sometimes, it may be recommended to limit your diet even more. […] Your provider will likely first prescribe an acid blocker such as a PPI. This treatment is the easiest to use, but most people’s symptoms don’t improve. […] If you do not respond to the PPI, your provider will then likely prescribe a steroid, such as fluticasone or budesonide. This steroid is in a liquid form that is swallowed to treat eosinophilic esophagitis. This type of steroid is not absorbed into the bloodstream, so you are unlikely to have the typical side effects often associated with steroids.

• #24 Eosinophilic Esophagitis

  https://www.aaaai.org/conditions-treatments/related-conditions/eosinophilic-esophagitis

  Other medications have been shown to reduce the number of eosinophils in the esophagus and improve symptoms. Proton pump inhibitors (PPIs), which reduce acid production in the stomach, have also been found to be able to reduce esophageal inflammation in some patients with EoE. […] Corticosteroids, which control inflammation, are helpful medications for treating EoE. Swallowing small doses of corticosteroids so that they come into contact with the inner lining of the esophagus is the most common treatment. […] Once esophageal inflammation is adequately controlled, the dose of swallowed corticosteroid is decreased to the smallest dose necessary to maintain control of EoE in order to reduce the risk of steroid side effects. […] It is important that your gastroenterologist and allergist work together and agree on how to take care of your EoE. If you are following a diet to treat your EoE, working with a dietitian who knows about elimination diets used to treat EoE is highly recommended.

• #25 Esophagitis – Children’s Hospital of Orange County

  https://choc.org/programs-services/gastroenterology/esophagitis/

  Esophagitis can have serious consequences that can affect a child’s quality of life. If left untreated, esophagitis may develop into a condition called Barrett’s esophagus that increases the risk for esophageal cancer. […] Treatment for esophagitis depends on the cause. At CHOC, all treatment plans are planned with the assistance of your child’s family and other members of your child’s medical team—including other physicians and dietitians involved in your child’s care. Possible treatments can include: […] Lifestyle changes. If the esophagitis is caused by GERD, your child’s gastroenterologist might offer these recommendations: – Raise the head of the child’s bed so that they sleep with their head slightly above their feet. – Change the child’s eating habits to limit acid or irritation of the esophagus. This might mean switching to a bland diet for a while and avoiding spicy foods, citrus foods, chocolate, fatty foods and caffeine. – Maintain a healthy weight. – Become more active. – For adolescents and young adults, this also may include quitting smoking and alcohol.

• #26 Esophagitis – Children’s Hospital of Orange County

  https://choc.org/programs-services/gastroenterology/esophagitis/

  Acid-blocking medicines. […] Additional medications. In some cases, the gastroenterologist may prescribe drugs to help the stomach empty and prevent esophagitis. […] Dietary changes. Changing your child’s diet to help with reflux or address the needs of a patient diagnosed with eosinophilic esophagitis. […] Surgery. Surgery may be recommended if your child has bleeding or narrowing of the esophagus. It also might be recommended if needed to control the spread of precancerous cells.

• #27 Eosinophilic Esophagitis (EoE) Treatment | Children’s Hospital Colorado

  https://www.childrenscolorado.org/doctors-and-departments/departments/digestive-health/programs/eosinophilic-gastrointestinal-diseases/eoe-treatment/

  Our registered dietitians can help you find a diet that controls your child’s symptoms while providing nutrients for their growing body. […] Topical corticosteroids, such as fluticasone or budesonide, were originally developed for asthma patients but can also provide relief for children with EoE. Kids and teens can take the steroid as a liquid or from an inhaler. The steroid coats the esophagus, decreasing the number of eosinophils and allowing the esophagus to heal. […] EoE is a lifelong condition, which means it requires lifelong treatment. We carefully evaluate treatment methods, weighing the risks and benefits to ensure the best possible quality of life for your child. […] Although steroids are a highly effective treatment method for many children with EoE, they are not always required. We strive to recommend the treatment methods we feel will successfully treat your child’s esophageal inflammation and give them the best quality of life. Your doctor will explain the benefits and risks of each method to help you make an informed decision. […] Elimination diets are still an effective treatment method for EoE, even without medication.

• #28 Treatment for Eosinophilic Esophagitis in Children | GI Care for Kids

  https://www.gicareforkids.com/conditions-we-treat/eosinophilic-esophagitis/

  Proton pump inhibitor therapy (omeprazole, lansoprazole, or esomeprazole, among others) includes medications traditionally used for acid reflux. However, these medications also have anti-inflammatory qualities and have been shown to be effective in up to 50% of patients with EoE. […] Dietary therapy includes elimination of certain foods that commonly trigger EoE. The most common food triggers include milk, soy, egg, and wheat. Your doctor may initially recommend excluding all four of these foods or may recommend eliminating one or two at a time. These customized, empirical diets have been shown to be effective in up to 70% of children with EoE. […] In children with severe and unresponsive EoE, another dietary approach is the elemental diet, where all sources of intact proteins are eliminated, and patients are supported with a fully broken-down (“elemental”) formula. While these dietary changes can be difficult to maintain, this therapy has been shown to be effective in nearly 100% of children with EoE. […] Regardless of the type of dietary therapy, however, the ultimate goal is to find the specific foods that are triggering the inflammation, which will allow your child to have the least restrictive diet possible.

• #29 Esophagitis in Small Animals – Digestive System – Merck Veterinary Manual

  https://www.merckvetmanual.com/digestive-system/diseases-of-the-esophagus-in-small-animals/esophagitis-in-small-animals

  Mild esophagitis may require no treatment. If clinical signs are present, medical treatment should be instituted. Esophagitis secondary to gastroesophageal reflux is treated by decreasing gastric acidity, increasing lower esophageal sphincter tone, increasing the rate of gastric emptying, and providing pain control. […] In most cases, H2-receptor antagonists (eg, ranitidine, famotidine) are sufficient to decrease gastric acid production; however, in severe cases of esophagitis, a proton pump inhibitor (eg, omeprazole) is preferred. […] Cisapride and metoclopramide increase lower esophageal tone and the rate of gastric emptying. Cisapride is more potent than metoclopramide. A sucralfate slurry may also be administered orally for esophageal protection. Soft food, low in fat and fiber, should be fed in small, frequent meals. Systemic analgesics may be administered for pain relief.

• #30 Esophagitis in Small Animals – Digestive System – Merck Veterinary Manual

  https://www.merckvetmanual.com/digestive-system/diseases-of-the-esophagus-in-small-animals/esophagitis-in-small-animals

  If esophagitis is severe, a gastrostomy tube may be used to completely rest the esophagus. Oral administration of a cocktail of antacid and anaesthetic lidocaine may be beneficial in cases of severe esophagitis. The administration of corticosteroids to prevent esophageal stricture formation is controversial. Broad-spectrum antimicrobials should be administered for concurrent aspiration pneumonia and may be useful in severe esophagitis as an attempt to prevent bacterial invasion and infection.

• #31 Eosinophilic Esophagitis Treatment Options | myEoEcenter

  https://eoe.myhealthteam.com/resources/eosinophilic-esophagitis-treatment-options

  One biologic is FDA-approved to treat EoE dupilumab (Dupixent). […] This medication was approved in 2022 for adults or adolescents 12 years old and up. […] Esophageal dilation is a procedure that can help widen the esophagus and make eating easier. […] You may choose to try this procedure if medications aren’t helping or if you don’t want to deal with their side effects. […] Esophageal dilations can be very effective, helping improve symptoms for 95 percent of people. […] To determine the optimal approach for treating your EoE, you may want to talk over the options with your primary physician as well as with other health care providers, such as your gastroenterologist, allergist, or dietitian. […] It may take some trial and error before you find the right treatment plan.

• #32

  https://www.eosnetwork.org/eoe-treatment

  For EoE patients aged 11+ in the USA, EOHILIA (budesonide oral suspension) was approved by the FDA in February 2024. […] For children with EoE and in countries where these specifically designed treatments are not yet available, oral topical steroids are given via either an asthma-style pump containing fluticasone, which you swallow rather than inhale; or by mixing repsules of budesonide to make a thick liquid, which you swallow to coat the affected area. […] Whichever way the budesonide or fluticasone is administered, pump spray swallowing fluticasone/budesonide slurry or tablet, it is very important that it is not washed off with liquid (drink or food) for as long as possible preferably overnight but a minimum of 1 hour. […] These drugs are often used for acid-related diseases (of which EoE is not one), and they can partially reduce the symptoms and signs of inflammation on biopsy in up to 50% of patients.

• #33 Eosinophilic Esophagitis – Digestive Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/digestive-disorders/esophageal-and-swallowing-disorders/eosinophilic-esophagitis

  Treatment includes proton pump inhibitors, corticosteroids, a biologic agent, changes in diet, and sometimes dilation of the esophagus. […] Options for adults include proton pump inhibitors (PPIs), which are medications that reduce production of stomach acid and can reduce symptoms; topical corticosteroids; and the biologic agent dupilumab. […] In children, changes in diet are often effective, but PPIs are typically used if changes to the diet have not helped. […] If PPIs do not help, people are given topical corticosteroids (such as fluticasone and budesonide) that are swallowed. […] Dupilumab is a biologic agent that is given by injection. […] Doctors may instruct people to change their diet. […] If people have narrowing of the esophagus, doctors inflate a balloon in the esophagus during endoscopy to dilate it. […] Injection and infusion therapies that target the eosinophil pathway in the body are being studied for eosinophilic esophagitis.

• #34 Eosinophilic Esophagitis | Symptoms & Treatment | ACAAI Public Website

  https://acaai.org/allergies/allergic-conditions/eosinophilic-esophagitis/

  Another possible treatment is the elemental diet, a special liquid or powder nutrition replacement taken for up to six weeks to allow your esophagus time to heal. […] Esophageal dilatation: If your esophagus gets too narrow, your doctor may recommend stretching it. […] Biologic therapy: Biologics are newer, targeted therapies that reduce inflammation. Biologics are provided by injection or IV (intravenous). The FDA approved dupilumab (Dupixent®) in 2022 as a treatment for EoE. Benralizumab (Fasenra®), another biologic, has orphan drug designation. The FDA may approve other biologics for EoE in the near future.

• #35 Treatment Guidelines | Consortium of Eosinophilic Gastrointestinal Disease Researchers

  https://cegir.rarediseasesnetwork.org/resources/researchers-clinicians/treatment-guidelines

  Many consider PPIs as first-line therapy since this medication has been used for a long time for non-EoE indications. […] The TCS can not only alleviate the eosinophilic inflammation in the esophageal epithelium, but also lower epithelial cell apoptosis, decrease esophageal molecular remodeling, reduce the dilated intercellular spaces, and downregulate mast cell activity. […] With a greater understanding of the molecular mechanisms underlying EoE, limitations and side effects of existing therapeutic approaches, and advances in biotechnological methods, there is burgeoning interest in developing biologic therapies for EoE. […] Currently, repeated EGD with biopsies is required for diagnosing and monitoring EoE. EGD also has a crucial therapeutic role in the management of esophageal strictures, EFIs, and related complications, including esophageal perforation and bleeding.

• #36 Esophagitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK442012/

  Treatment depends on the etiology but core principles of treatment in addition to etiology specific treatment include acid suppression with PPI or H2 blockers, lifestyle modification, liquid to soft or puree diet to allow adequate time for healing and dietary modification. […] If the etiology appears to be acid reflux based on history then the use of H2 blockers twice a day or proton-pump inhibitors daily is indicated initially. Patient should also be advised of lifestyle and dietary modifications which include weight loss, elevating the head end of bed (patient with nocturnal symptoms of cough, hoarseness, sore throat), elimination of some dietary triggers such as fatty food, chocolate, carbonated drinks, spicy food, smoking, and alcohol. […] If the etiology is medication-induced esophagitis, the medication should be stopped if possible and if necessary then should be switched to any other alternatives. The patient should be instructed to take pills with 4 oz of water and remain upright for 30 min after taking the pills.

• #37 A Look at the Updated ACG Eosinophilic Esophagitis Clinical Guidelines – American College of Gastroenterology

  https://gi.org/journals-publications/ebgi/eluri_feb2025/

  Dupilumab is an option for patients who are treatment-resistant to initial therapies, and also those with multiple atopic conditions. Dilation therapy is also available and can be used concomitantly with anti-inflammatory treatment. […] After treatment initiation, the disease should be monitored not just by symptoms alone as symptoms do not reliably correlate with endoscopic/histologic findings. […] Maintenance therapy is necessary to prevent recurrence, and pediatric considerations include evaluation with esophagram in the setting of dysphagia and adjunctive feeding therapy for children with feeding dysfunction. […] Treatment involves shared decision-making, with first-line options including dietary elimination (starting with less restrictive approaches) or pharmacologic therapy (PPI or topical steroids). Endoscopic dilation is advised for strictures but should be combined with anti-inflammatory treatment.

Zobacz więcej