Eosinophilic esophagitis: A newly established cause of dysphagia

Table 5 Treatment regimens for eosinophilic esophagitis

Treatment option	Protocol
Elimination Diet	Avoidance of allergen depending on results of food allergy testing
	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: Mayo Clinic protocol	Fluticasone 220 μg puffer 4 puffs BID x 6 wk, swallowed, no spacer
	Rinse mouth with water and spit out
	No food or drink for 3 h after dose
Systemic (oral) corticosteroids	Methylprednisolone 1.5 mg/kg per day (or equivalent dose prednisone)
	Divide into bid dosing for 4 wk then taper over 6 wk
Montelukast	Initial dose: 10 mg po daily
	Titration: Dose up to 100 mg/d depending on symptoms and tolerance
	Maintenance: Once symptoms relieved titrate down to minimal dose to maintain remission (usually 20 - 40 mg/d)
Mepolizumab	10 mg/kg iv infusion q 4 wk x 3 doses

BID: twice daily; PO: oral; IV: intravenous.