Talk to Your Doctor About These Options
Eosinophilic Esophagitis (EoE) is a chronic immune system disease. Effective treatment is essential to manage symptoms, reduce inflammation and improve quality of life. Below are some of the most common treatment options for EoE, starting with Eohilia.
1. Eohilia
Eohilia is an oral solution of budesonide specifically formulated to treat EoE. Budesonide is a corticosteroid that reduces inflammation by suppressing the immune response in the esophagus. Unlike traditional swallowed steroids, Eohilia is designed to coat the esophageal lining effectively, ensuring better contact with inflamed tissues.
When taken orally, Eohilia adheres to the esophageal walls, targeting inflammation and reducing the buildup of eosinophils. This helps alleviate symptoms such as difficulty swallowing and chest pain.
Benefits
- Eohilia has demonstrated effectiveness in reducing inflammation and improving swallowing function.
- It provides an easier delivery method for patients compared to other corticosteroids.
2. Proton Pump Inhibitors (PPIs)
PPIs, such as omeprazole and esomeprazole, are commonly used to treat acid reflux but have also been found effective in managing EoE symptoms. Although their exact mechanism in EoE treatment is not fully understood, PPIs can help reduce inflammation and esophageal eosinophil counts.
PPIs decrease the production of stomach acid, which may contribute to inflammation in some EoE patients. They also have anti-inflammatory properties that help lower eosinophil activity in the esophagus.
Benefits
- Non-invasive and easy to administer (oral tablets or capsules).
- Can help differentiate between acid reflux and true EoE.
- Effective for some patients in reducing inflammation.
3. Topical Corticosteroids
Topical corticosteroids like fluticasone or oral budesonide (in slurry form) are widely used for EoE. These medications are typically swallowed rather than inhaled, allowing the drug to directly coat the esophagus.
Swallowed corticosteroids suppress the immune response in the esophageal lining, reducing eosinophil buildup and inflammation.
Benefits
- Proven to be effective in reducing symptoms and inflammation.
- Can be combined with other therapies for enhanced results.
- Easy to administer as part of daily routines.
Challenges
- Long-term use may cause side effects such as oral thrush.
- Requires careful adherence to treatment guidelines.
4. Elimination Diet
Dietary management is a non-pharmacological approach to treating EoE, particularly for patients where food allergens are a trigger. An elimination diet involves removing specific foods that are most likely to cause EoE symptoms, such as dairy, wheat, soy, nuts, fish and eggs.
Patients follow an elimination diet, systematically removing and reintroducing potential allergens under the supervision of a healthcare provider. This helps identify which foods trigger EoE symptoms.
Benefits
- Non-invasive and avoids medication side effects.
- Allows patients to personalize their diet based on triggers.
Challenges
- Requires strict dietary discipline and guidance.
- May need a dietitian’s support for balanced nutrition.
5. Biologic Therapies
Biologic therapies, such as monoclonal antibodies, are emerging treatments for EoE. These therapies target specific pathways in the immune system that contribute to eosinophil buildup and inflammation. For instance, therapies targeting interleukin-5 (IL-5) have shown promise in clinical trials.
Biologics work by blocking the signaling pathways responsible for eosinophil activation and recruitment in the esophagus.
Benefits
- Potential for targeted treatment with fewer systemic side effects.
- Effective for patients who do not respond to standard therapies.
Challenges
- May be expensive and require regular injections or infusions.
- Still undergoing research for long-term efficacy and safety.
6. Esophageal Dilation
Esophageal dilation is a procedure used to treat narrowing (strictures) in the esophagus caused by long-term inflammation. It is typically reserved for patients with severe difficulty swallowing.
During the procedure, a balloon or dilator is used to gently stretch and widen the narrowed esophagus, improving swallowing function.
Benefits
- Provides immediate relief from esophageal strictures.
- Can improve quality of life for patients with severe symptoms.
Challenges
- Does not treat the underlying inflammation.
- Risks include bleeding or perforation of the esophagus (though rare).
Final Notes
Eosinophilic esophagitis requires a multifaceted approach to treatment, combining medical therapies, dietary modifications and, in severe cases, procedures like esophageal dilation. Patients should work closely with their healthcare providers to identify the most suitable treatment plan based on their individual condition and triggers. By following a tailored treatment strategy, patients can significantly improve their quality of life.