Treatment
What Treatment Option Would You Prescribe for Daniel’s EoE?
View Treatment1,2
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Proton Pump Inhibitor
Swallowed Topical Corticosteroid
Empiric Elimination Diet
Elemental Diet
Esophageal Dilation
Case based on hypothetical patient.
EoE, eosinophilic esophagitis;
1 Lucendo AJ, et al. United European Gastroenterol J. 2017;5(3):335-358.
2 Hirano I, et al. Gastroenterology.
Proton Pump Inhibitor
*Histologic remission was defined as <15 eos/hpf from a meta-analysis of 23 studies, most of which were single-arm,
retrospective studies.1,2
AGA, American Gastroenterological Association; EoE, eosinophilic esophagitis; eos/hpf, eosinophils per high-power field; JTF, Joint Task Force on
Allergy-Immunology Practice Parameters; PPI, proton pump inhibitor.
1.Hirano I, et al. Gastroenterology.
2. Rank MA, et al. Gastroenterology. 2020;158:1789-1810.
Swallowed Topical
Corticosteroid
*Histologic remission was defined as
<15 eos/hpf from meta-analysis of 8 studies.1,4
AGA, American Gastroenterological Association; CS, corticosteroid; EoE, eosinophilic esophagitis; eos/hpf, eosinophils per high-power field; JTF,
Joint Task Force on Allergy-Immunology Practice Parameters; STC, swallowed topical corticosteroid.
1. Hirano I, et al. Gastroenterology.
2. Rank MA, et al. Gastroenterology.
2020;158(6):1789-1810.
3. Lucendo AJ, et al. United European Gastroenterol J.
2017;5(3):335-358.
4. Hirano I. Gastroenterology. 2018;155(3):601-606.
5. COREOS Collaborators. J Allergy Clin Immunol. Published online July 6.
doi:10.1016/j.jaci.2021.07.001.
6. Beveridge C, Falk GW. Gastroenterol Hepatol (NY). 2020;16(6):294-301.
Empiric
Elimination Diet
*Six foods: cow’s milk, wheat, egg, soy, peanut/tree nuts, fish/seafood4; exclusively testing-based elimination diets are not
recommended due to the potential limited accuracy of currently available allergy-based testing for the identification of specific food triggers.1
AGA, American Gastroenterological Association; 1FED, 1-food elimination diet; EGD, esophagogastroduodenoscopy; EoE, eosinophilic esophagitis; eos/hpf,
eosinophils per high-power field; JTF, Joint Task Force on Allergy-Immunology Practice Parameters; SFED, six-food elimination diet.
1. Hirano I, et al. Gastroenterology.
2. Chang JW, et al. Gastroenterol Clin North Am. 2021;50(1):59-75.
3. Kliewer K, et al. Presented at the Virtual Digestive Disease Week, May 21-23, 2021; Abstract 535.
4. Lucendo AJ, et al. United European Gastroenterol J. 2017;5(3):335-358.
Elemental Diet
*May require use of nasogastric tubes in most children.1,2
AGA, American Gastroenterological Association; EoE, eosinophilic esophagitis; JTF, Joint Task Force on Allergy-Immunology Practice Parameters.
1. Hirano I, et al. Gastroenterology.
2. Lucendo AJ, et al. United European Gastroenterol J. 2017;5(3):335-358.
Esophageal Dilation
Figure reprinted from Gastrointest Endoscopy, Vol 86, Issue 1, Adler DG and Siddiqui AA, Endoscopic management of esophageal strictures, graphical abstract, Copyright 2017, with permission from Elsevier.
AGA, American Gastroenterological Association; EoE, eosinophilic esophagitis; JTF, Joint Task Force on Allergy-Immunology Practice Parameters.
1. Hirano I, et al. Gastroenterology.
2. Richter JE. Am J Gastroenterol. 2016;111(2):214-216.
3. Adler DG, Siddiqui AA. Gastrointest Endosc. 2017;86(1):35-43.
4. Lucendo AJ, et al. United European Gastroenterol J. 2017;5(3):335-358.
5. Runge TM, et al. Am J Gastroenterol. 2016;111(2):206-213.