What Is the Treatment of Eosinophilic Esophagitis?
Eosinophilic esophagitis (EoE) is managed with a structured first-line anti-inflammatory strategy. Guidelines advise selecting a single initial therapy and evaluating its effect through both endoscopic and histologic assessment.
Initial Therapy
Management begins with selecting one anti-inflammatory approach — either a medication-based option or a dietary strategy — based on clinical considerations. The specific choice, its parameters, and how it is administered are detailed in the full structured protocol.
Complete regimen details and selection criteria are available in the full protocol.
Response Goals
Treatment response is assessed by endoscopy with biopsies at 8–12 weeks. The protocol defines specific thresholds for histologic improvement, endoscopic improvement, and symptomatic relief of esophageal dysfunction.
References
DOI: 10.14309/ajg.0000000000003194
- We suggest PPIs as a treatment for EoE.
- We recommend the use of swallowed topical steroids as a treatment for EoE.
- We suggest an empiric food elimination diet as a treatment for EoE.
- In general, we advise that a single anti-inflammatory therapy is initially selected, and treatment response is assessed by clinical, endoscopic, and histologic disease activity.
- We recommend evaluating response to treatment of EoE with assessment of symptomatic and endoscopic and histologic outcomes.
- In general, the recommendation is to perform an endoscopy to assess treatment response in 8–12 weeks after starting a new therapy such as PPI, STC, or FED.
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