Eosinophilic esophagitis treatment begins with proper diet and medication. If it does not produce any improvement, then esophagus dilatation is the only option.
Eosinophilic Esophagitis Treatment
The treatment of eosinophilic esophagitis is with eosinophilic esophagitis diet and medications; if it failed to produce a result, then suggest a gentle dilatation of the esophagus. The purpose of treatment is to relieve symptoms of dysphagia.
Eosinophilic Esophagitis Diet
As said before eosinophilic esophagitis is a type of esophagitis caused by allergic reaction. It has considered that certain protein diet is finding to be allergic for many individuals.
Diagnosis of allergic to food is by skin prick testing and atopy patch testing, the result only doubts to allergic or not for any particular food.
- Egg, milk, and soy has identified as allergic foods with skin prick testing in most cases.
- Corn, soy, and wheat has identified as allergic foods with atopy patch testing in most cases.
Many physicians instead of going for skin prick or atopy testing, they simply suggest a six-food elimination diet (SFED). SFED is a restricted food from six of the most common food allergens. These most important six food allergens are:
- Cow's milk protein (casein),
- Peanut/tree nuts,
Patient with Eosinophilic esophagitis can manage and treat effectively along with medication by following a diet that does not contain the above said six food items. In addition, it is advisable to eliminate processed foods that contain any known or suspected ingredient.
There is no one best diet treatment method for every person with eosinophilic esophagitis. You need to try/correct to achieve a d diet plan for you. It is best to blend this dietary treatment with proper medication for effective and early result to relieve from swallowing difficulty.
Medications for Eosinophilic Esophagitis
The medications useful for the treatment of eosinophilic esophagitis are:
- Fluticasone propionate (Flovent) - a steroid
- Proton pump inhibitors (Protonix, Nexium, Aciphex, Prevacid, Prilosec, and Zegarid) – a reduce production of acid by the stomach.
Fluticasone propionate (Flovent)
The medication treatment for eosinophilic esophagitis is oral administration of fluticasone propionate. Fluticasone propionate is a synthetic man made steroid similar to naturally made steroids such as cortisol or hydrocortisone manufactures by the adrenal glands. These steroids have a potent anti-inflammatory property.
Fluticasone propionate is useful as an inhaler to reduce inflammation in the airways for asthma patients. It provides relief from wheezing and breathing difficulty. Similarly, fluticasone propionate when swallowed reduces inflammation and eosinophil count in the esophagus and provides relief from swallowing difficulty (dysphagia).
Fluticasone propionate is administering with the same inhaler used for asthma treatment but in this case, deposited in the mouth rather than in the lungs. After administration of fluticasone propionate, the patient is requested to drink small quantity of water and there after they should not eat or drink anything for two hours after treatment. Usually, this treatment is suggesting two times a day for several weeks. One can expect improvement in dysphagia within few days to weeks of treatment.
A treatment with small quantity of fluticasone propionate then little quantity of this steroid has absorbed by the body and may cause some minor side effect. The most common side effect is an infection of the mouth and throat by a fungus called Candida.
Proton pump inhibitors
Proton pump inhibitors such as pantoprazole (Protonix), esomeprazole (Nexium), rabeprazole (Aciphex), lansoprazole (Prevacid), and omeprazole (Prilosec, Zegarid, Kapodex) are useful for the treatment of eosinophilic esophagitis.
What is a proton pump inhibitor? Proton pump inhibitor is useful to reduce the secretion of acid by the stomach. Proton pump inhibitors are safe and effective treatment for the acid reflux and esophagitis. Since acid reflux may aggravate eosinophilic esophagitis, so prescribe proton pump inhibitors to stop this aggravation. However, fluticasone or other steroid is usually required to treat eosinophilic esophagitis.
Patients of eosinophilic esophagitis with dysphagia have to treat with esophageal dilatation.
Esophageal dilation is performing by physically removing the obstruction in the esophagus tube by stretching or fracturing the obstruction. Perform esophageal dilatation by using endoscopy or by inserting an empty balloon into the esophagus using endoscopy and positioning it exactly at the abnormal area (obstruction) of the esophagus and inflates the balloon to break down the obstruction.
Esophageal dilatation is considering being effective and generally safe. Some may develop tears in the esophageal lining, which causes severe chest pain after esophageal dilatation. In rare cases, the entire esophageal wall tears and causes serious complications of infections. Therefore, doctors more commonly prefer smaller dilatation with less force.
In addition, it is preferable to try medications to treat eosinophilic esophagitis with dysphagia and use esophageal dilatation only when the medications failed to produce a result.