Eosinophilic Esophagitis (EoE or EE) Treatment Options
Eosinophilic Esophagitis is a rare condition in which the esophagus becomes inflamed due to an allergic response in the esophagus. Since the disorder is complex, it can sometimes be difficult to treat. There has been a significant rise in the number of patients diagnosed with EoE so more treatment options are being explored by allergists. It is important to first understand that while there are drug therapy options available for those suffering from Eosinophilic Esophagitis, none of them are currently FDA approved.
EoE Treatment: Swallowed Inhaled Steroids
Swallowed Inhaled Steroids, otherwise known as topical steroids, are one of the most popular Eosinophilic Esophagitis treatments. This particular drug therapy requires the patient to swallow what was originally intended to be an inhaled medication for asthmatics. People with asthma use these medications to treat lung inflammation, and those who are in need of an EoE treatment use the medication to rid the inflammation that is prevalent in the esophagus. For those who have Eosinophilic Esophagitis from allergies, topical steroids are one of the main ways to treat it; in fact, it is often the only way in which these particular patients choose to treat this disease.
The two most popular types of steroids are budesonide (Pulmicort) and fluticasone (Flovent). If a patient decides to use Flovent, they should know that it is a metered dose inhaler (MDI). This type of medication is pumped manually in order to aerosolize the steroid. It is then pumped into the mouth and dry swallowed. Pulmicort, on the other hand, usually comes in a solution that is aerosolized through a nebulizer that is used for asthma patients. For those who want to use Pulmicort as an EoE treatment, it is typically combined with another element such as Splenda to produce a type of Slurry that is swallowed.
People who have an issue dry swallowing the Flovent medication prefer to use the Pulmicort. Patients who use swallowed steroids should not eat or drink anything for at least half-an-hour afterwards; this way, it will have enough time to properly coat the esophagus. In addition, it is highly important for anyone using these steroids to brush their teeth after every use to remove any residue. This is extremely necessary because if there are remnants of these steroids left over they can cause negative side effects.
EoE Treatment: Swallowed Inhaled Steroid Side Effects
Unfortunately, using swallowed inhaled steroids as an Eosinophilic Esophagitis treatment can lead to negative side effects. The most common side effect is called esophageal candidiasis, and it is basically a yeast infection of the throat. This condition begins with an intense pain in the throat. If a patient is experiencing this, it is imperative that they notify their physician immediately; esophageal candidiasis is typically treated with anti fungals. There are some who cannot use swallowed inhaled steroids as an Eosinophilic Esophagitis treatment because they have repeated throat yeast infections. Another side effect that has occurred with topical steroids is dry mouth. In addition, there has been one report of a patient contracting herpes infection of the esophagus after using fluticasone.
EE Treatment: Multidisciplinary Centers
Due to the fact that Eosinophilic Esophagitis is a highly complex disease that is still not very well known, patients who have it need to be seen by different physicians with different specialties. Furthermore, it is important for a patient to visit an allergist in order to go through an allergy evaluation, and it is also wise for them to visit a gastroenteologist in order for their symptoms to be analyzed, and the EoE to be observed through endoscopies (EGD).
It is also in the patient's best interest to see a pathologist because they will have the ability to decipher the findings of the esophageal biopsy. A dietician is also very important to help the patients who decide to use dietary therapy as their Eosinophilic Esophagitis treatment. There are many patients who benefit greatly from the help of a therapist or social worker because of the stress this disease can cause. There are numerous physicians a patient with EoE should consult with, but it is also important for all of the doctors to communicate with each other. For this reason, it is in the patient's best interest to go to a multidisciplinary center. Typically, at this type of center that specializes in Eosinophilic Esophagitis treatment, they schedule patients for multiple appointments in one day; this way the patient can be evaluated as quickly as possible thus making everything extremely more convenient.
Although EE is a very complex disorder, there are several treatment methods that have proven effective for eliminating symptoms. By using a combination of medication, diet, and multidisciplinary therapies, patients can learn to live a normal lifestyle.