How is Eosinophilic Esophagitis Treated?

Treatment for eosinophilic esophagitis is complex and ideally involves a multidisciplinary team of healthcare professionals:

gastroenterologists (focus on esophageal damage and complications)
allergists (focus on allergic testing and identifying food triggers)
psychologists (work with patients and families to create healthy habits and coping skills)
dietitians (create a nutrition plan based upon patient’s dietary preferences)
feeding specialists (create short- and long-term treatment plans for healthy eating that work for the patient)

These healthcare professionals collectively provide the best care for patients with EoE. Additionally, there are several different approaches to treatment for EoE that are delivered separately by these specialists. Treatment for EoE includes one or more of the following three options:

Dietary Therapy

The diet of patients with EoE will be modified to identify and then avoid triggers of esophageal inflammation. Common triggers for patients with EoE are dairy, wheat, soy, and eggs. The type of dietary therapy used, such as an elemental diet (no allergens) or an elimination diet (fewer allergens), will be decided by the healthcare team working together with the patient and their family.

Medication

Two long-standing treatments for patients with EoE are proton pump inhibitors (PPIs) and topical steroids. Treatment with PPIs blocks acid production and helps the lining of the esophagus heal from inflammation. Patients can also be treated with topical steroids, which usually is a liquid mixture, absorbed into the esophageal lining to lower the level of inflammation. There is now a new medication available, dupilumab, which is also effective and has been approved by the Food and Drug Administration (FDA) for use by adolescents and adults to treat EoE.

Dilation

Patients who are still having trouble swallowing food after taking topical steroids will benefit from having their esophagus dilated, or stretched to open wider.