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Conferences and Medical Updates

Eosinophilic Esophagitis

EoE
No EoE in Africa
More common in men
Familial clustering
Mean age is 34 of diagnosis
Associated with food or seasonal allergies
Caucasian predominance
T cells with increased production of IL 13
If Eos present in stomach or duodenum think CD, eosinophilic gastroenteritis
Other causes of Eos in Eso includes CD,
PPI-REE (ppi responsive EoE). Patients have EoE by bx and symptoms but give them PPI and they feel better!
Usually have dysphagia and look for classic eosiniophilic morphology
Try PPI for 8 weeks, repeat EGD and see if EoE has resolved.
Stricture and food dysfunction swallow is a problem
topical steroids, six food elimination diet, elemental diet, tailored diet, therapeutic endo dilatation. No role for singulair
Fluticasone and Budesonide were studied Maxiumum 4 puffs twice a day to 1 mg budesonide a day
Ciclesonide – topical glucocorticoid and converted to active form in esophagus.
Elemental diet – amino acid formula, most effective and removal all allergenic 98% effective
milk eggs, soy, wheat peantus tree nuts and shellfish – Six food elimination diet diet 80% effective
Perforation rate was 0.3% for dilatation. Do it only after pt has been treated for 6 weeks.
Dilate to 16 mm diameter or more
Reslizumab – anti IL 5 medication for treatment