3-yr-follow-up of topical corticosteroid treatment for eosinophilic esophagitis in adults.
BACKGROUND
Eosinophilic esophagitis (EE) is a clinicopathologic syndrome comprising isolated eosinophilic inflammation of the esophagus, with symptoms of dysphagia, and possibly, reflux. It was initially described in children, and in recent years, there is a heightened awareness in adults. The etiology is not completely understood. The treatments include dietary manipulation, topical corticosteroids, systemic corticosteroids, Montelukast, and endoscopic dilation. In adults, there are no randomized trials demonstrating the efficacy of any particular treatment, and no prospective studies describing the natural history of the disease following treatment.


METHODS
We performed an interval follow-up of patients treated with a swallowed corticosteroid inhaler. We contacted 51 adult patients who were diagnosed with EE and treated with a swallowed corticosteroid inhaler between September 1, 1999, and May 31, 2003. All patients had received 6 wk of treatment with fluticasone 220 mEq/puff, four puffs swallowed twice daily for 6 wk.


RESULTS
Thirty-two patients replied (63%) with a mean follow-up duration of 3.3 yr. Ninety-one percent of patients reported recurrent symptoms; a mean of 8.8 months after treatment was completed. Sixty-nine percent of patients repeated treatment with the steroid inhaler at least once.


CONCLUSIONS
It appears that EE is a chronic remitting disorder that requires more than one topical steroid treatment course.
Helou
Emelie F
EF
Department of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Simonson
Julie
J
Arora
Amindra S
AS
D000287:Administration, Topical; D000328:Adult; D000730:Androstadienes / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D003680:Deglutition Disorders / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D004802:Eosinophilia / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D004941:Esophagitis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D000068298:Fluticasone; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009330:Nebulizers and Vaporizers; D012008:Recurrence; D016896:Treatment Outcome
D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D000068298:Fluticasone