Collections > Master's Papers > Gillings School of Public Health > A Novel Treatment Approach For Pediatric Eosinophilic Esophagitis: 2 Food Elimination Diet In Combination With Swallowed Steroids
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Eosinophilic Esophagitis (EoE) is a serious, chronic disorder that has been increasing in incidence and prevalence, and without adequate treatment, is associated with substantial morbidity. Given the lack of consensus on best practice for treating EoE, the invasiveness and potential side effects of current treatments, as well as the likelihood of recurrence of symptoms after discontinuing treatment, we propose a pilot study to explore a novel treatment approach for EoE in the pediatric population. No studies have been published on the efficacy of combining the 2 most common maintenance treatments, swallowed steroids and an elimination diet. In a cohort study with 38 newly diagnosed patients, this treatment protocol combines and simplifies steroid and diet therapy. Patients will be treated on dedicated clinic days by the pediatric gastroenterologist and dietitian in Wake Forest Baptist’s pediatric GI program designed to provide continuity of care and ongoing education and support to our patients and families of patients living with allergic digestive disorders. The therapy initially combines swallowed steroids and a 2-food elimination diet (dairy and soy) for 3 months to relieve symptoms, then alternates treatment with only 2- food elimination for 3 months, then only steroids for 3 months. Patients will undergo endoscopies 3 times throughout treatment after diagnosis to monitor resolution of symptoms over 9 months. We hypothesize that a study on this approach will demonstrate resolution of clinical symptoms, histological improvement, strong adherence to treatment, and increased quality of life while decreasing the potential for harmful side effects of treatments and the burden of an extensive elimination diet.