{"id":198,"date":"2010-07-12T22:55:14","date_gmt":"2010-07-13T02:55:14","guid":{"rendered":"http:\/\/blogstemp3.wpengine.com\/?p=198"},"modified":"2010-07-12T22:55:14","modified_gmt":"2010-07-13T02:55:14","slug":"im-back-so-how-do-you-treat-eosinophilic-esophagitis","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/im-back-so-how-do-you-treat-eosinophilic-esophagitis\/2010\/07\/12\/","title":{"rendered":"I&#8217;m back! So how do you treat eosinophilic esophagitis?"},"content":{"rendered":"<p>Eosinophilic esophagitis has been around for a long time but we only recently have recognized it and begun to try and treat it. My dilemma has been how and for how long should I treat this patient. Part of the decision difficulty lies in the extreme variation of clinical presentation that I see in this disease and part is related tot he lack of good quality treatment information.<\/p>\n<p>For example, do we treat all patients with topical steroids (inhaled steroids that are swallowed) and if so for how long (intermittent courses, maintenance long-term therapy, once)? Or are some better treated with other anti-inflammatory products? Treat first, dilate after or dilate then treat? What is the role for dietary modification in adult patients?<\/p>\n<p>So I am asking you to weigh in one these issues:<\/p>\n<p>Do you treat all adult patients with newly diagnosed eosinophilic esophagitis with oral inhaled then swallowed steroids (fluticasone)?<\/p>\n<p>If so how long?<\/p>\n<p>In those with a stricture or narrowed esophagus do you \u00a0dilate first then treat or treat then dilate?<\/p>\n<p>If you do not use steroids or they fail, what do you use to treat eosinophilic esophagitis?<\/p>\n<p>Let me know what you do, I look forward to hearing from you.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Eosinophilic esophagitis has been around for a long time but we only recently have recognized it and begun to try and treat it. My dilemma has been how and for how long should I treat this patient. Part of the decision difficulty lies in the extreme variation of clinical presentation that I see in this [&hellip;]<\/p>\n","protected":false},"author":28,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-198","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/posts\/198","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/users\/28"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/comments?post=198"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/posts\/198\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/media?parent=198"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/categories?post=198"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/gastroenterology\/index.php\/wp-json\/wp\/v2\/tags?post=198"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}