Bruno Queiroz Sander1*, Christian Follador Melado2, Helen Brum Barcellos3, Edson Portela4, Adilson Renato Veríssimo5, Aline Damasceno de Avance6, Guilherme Camarotti de Oliveira Canejo7, Flávio Rogério Hoerlle8, Tiago Alves de Moura9, Rolando Edward Marca Oliveira10, José Alberto da Silva11, Joao Marcelo Guimarães Marques12, Amanda Torres Coelho13, Paulo Ricardo Ramos Mendonça Filho14, Erson Ramires Alves Barbosa15, Lincoln Cruz Dantas16, Raielly Coutinho Barbosa17, Carlos Henrique Rodrigues Castro18, Felipe Antonio de Rezende19, Francisco Eduardo Moraes de Oliveira20, Alexandre Salomão de Barros oliveira21, Leonardo Teixeira Rodrigues22 and Jonas Pinto Vieira23
1Sander Medical Center, Brazil
3Gastrocirurgica- Clínica do Aparelho Digestivo, Brazil
4Hospital Portela, Brazil
5Universidade Federal de Juiz de Fora, Brazil
6Unifadra-Faculdade de Medicina de Dracena, Brazil
7Hospital da Unimed Caruaru, PE, Brazil
8Hospital de Caridade de Ijui-HCI, Brazil
9Hospital dos Acidentados, Brazil
10Hospital Regional de Extrema, Brazil
11Saúde Center Clinica, Brazil
12Medic Gastro Center, Brazil
14Hospital Regional Dom Moura /PÉ, Brazil
15UniClim São Miguel-RN, Brazil
16Clínica Dr. Lincoln Dantas, Brazil
17Universidade Federal do Amapá, Brazil
18Clínica São Francisco de Assis, Brazil
19Clínica Gastro Metropolitano, Serra, Espírito Santo, Brazil
20Clínica Maria de Nazaré-Pimenta Bueno-RO, Brazil
21Clínica MediFisio, Brazil
22Complexo hospitalar de Niterói, Brazil
23Endomed Clínica Médica, Brazil
*Corresponding Author: Bruno Queiroz Sander, Sander Medical Center, Brazil.
Received: March 29, 2021; Published: April 15, 2021
Eosinophilic Esophagitis is a chronic, immunologically mediated pathology characterized by eosinophil infiltrates in the esophageal mucosa, causing dysfunction of the organ. It can affect any age group, being more common in young people and with other atopics such as asthma, food allergy and allergic rhinitis. The symptoms presented by the patient can range from manifestations of gastroesophageal reflux, abdominal pain, to dysphagia and food impaction. The diagnosis is made through upper digestive endoscopy with biopsies demonstrating eosinophilic infiltrate greater than 15 eosinophils per field. This article has as main theme the treatment of maintenance of eosinophilic esophagitis, aiming to contextualize medical professionals with the therapeutic options used and the impact on clinical improvement and histological remission. Theoretical research started from non-experimental methodology, through literature review on the subject in recent years. The practical guidelines for the therapy of Eosinophilic Esophagitis should involve multidisciplinary follow-up with specialized professionals, such as gastroenterologist, nutritionist and allergist, being based on pharmacological and dietary measures. Dietary treatment consists of the identification of specific food allergens through tests or the empirical elimination diet of potentially more allergenic food groups. Clinical management includes an initial course with proton pump inhibitors. Topical corticosteroids (Fluticasone or Budesonide) are medications capable of reducing the eosinophilic inflammatory response and inducing histological and clinical improvement. Systemic courses of oral corticosteroids, such as Prednisone, may be necessary in patients with significant symptomatology. Endoscopic treatment, through esophageal dilation, is indicated in cases of symptomatic esophageal stricture. The choice of therapy will depend on the clinical picture, the histological analysis and the reported symptoms, as well as the preference of the physician, the patient and the costs.
Keywords: Eosinophilic Esophagitis; Elimination Diet; Corticotherapy; Fluticasone; Budesonide; Esophageal Dilation
Citation: Bruno Queiroz Sander., et al. “Maintenance Treatment of Eosinophilic Esophagitis”. Acta Scientific Gastrointestinal Disorders 4.5 (2021): 33-42.
Copyright: © 2021 Bruno Queiroz Sander., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.