Eosinophilic Esophagitis: Which Treatments Work-Which Don't?

August 14, 2013

Topical corticosteroids, special diets that eliminate the 6 most common food allergens, endoscopic dilation, and medical therapy effectively control symptoms. Mast cell inhibitors are not a recommended treatment.

Eosinophilic esophagitis is diagnosed in a 32-year-old man. He inquires about treatments to help control his dysphagia and reduce his episodes of food impaction. All of the following are treatment options to improve his symptoms, except . . .

a. Mast cell inhibitors
b. Topical corticosteroids
c. Specialized elimination diet
d. Endoscopic dilation

ANSWER: A


Patients with eosinophilic esophagitis may respond to topical corticosteroids and specialized diets that eliminate the 6 most common food allergens: wheat, milk, soy, egg, nut, and shellfish. Endoscopic dilation is one of the most effective means of controlling symptoms; however, this does not alter the underlying pathogenesis of the disease. Patients still need medical therapy. Mast cell inhibitors have not been shown to improve symptoms of eosinophilic esophagitis and are not a recommended treatment.