Table 5 Treatment regimens for eosinophilic oesophagitis
Treatment optionProtocol
Dietary therapy

  • Avoidance of allergen depending on results of food allergy testing

  • Six food elimination diet: milk, wheat, soy, egg, nuts, seafood

  • Oligoantigenic diet: eliminate large number of suspected foods and allow limited nutritionally balanced diet

  • Elemental diet: various formulas such as Neocate (free amino acids, corn syrup solids, medium chain triglycerides)

Topical corticosteroids

  • Fluticasone swallowed in divided doses:

        – children: 440–880 μg/day ×6–8 weeks
        – adolescents/adult: 880–1760 μg/day ×6–8 weeks

  • No spacer

  • No food or drink for at least 30 min after ingesting the dose

Systemic (oral) corticosteroids

  • Methylprednisolone 1.5 mg/kg/day (or equivalent dose prednisone)

        – divide into twice daily dosing ×4 weeks then taper over 6 weeks

  • Budesonide

        – children: 1–2 mg daily ×3–4 months
        – adults*: 2–12 mg daily ×2–6 weeks
Montelukast

  • Initial dose: 10 mg, orally, daily

  • Titration: dose up to 100 mg/day depending on symptoms and tolerance

  • Maintenance: once symptoms relieved titrate down to minimal dose to maintain remission (usually 20–40 mg/day)

Mepolizumab

  • 10 mg/kg intravenous infusion every 4 weeks ×3 doses

  • *Presented in abstract form only.62 67

  • This table is modified from Yan and Shaffer,21 with permission from the publishers.