Eosinophilic esophagitis, an inflammatory condition known as EE that often mimics reflux and can cause refusal to eat, affects about 1 in 2000 children in the United States and its prevalence is growing. Researchers from the Indiana University School of Medicine and Riley Hospital for Children report that treatment with oral or swallowed/sprayed steroids results in significant patient improvement, but that if discontinued relapse is common.

The results of a randomized clinical trial which compared prednisone and another commonly prescribed medication appears in the February 2008 issue of Clinical Gastroenterology and Hepatology.

EE can be a serious condition and cause children to refuse to eat, to vomit, or to get food stuck as the esophagus narrows from inflammation. EE, which does not improve without treatment, is twice as likely to occur in boys as in girls.

“We are seeing increasing numbers of children with EE who can benefit from effective therapy. Our study found that while systemic corticosteroids provided better initial patient improvement compared to swallowed steroids, long term results were similar between the groups,” said Sandeep K. Gupta, M.D., IU School of Medicine associate professor of clinical pediatrics and a Riley Hospital pediatric gastroenterologist.

“A child will often continue to suffer in silence if this disease is left untreated. We are not sure why the number of cases is increasing, but we are seeing an average of two new cases every week at Riley Hospital. As we study treatment options, we are also investigating how and why food allergies and environmental factors appear to play a role in this disease,” said Dr. Gupta.

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The Clinical Gastroenterology and Hepatology study was supported by a Clarian Values Grant, Clarian Health, Indianapolis.

Co-authors of the study are Elizabeth T. Schaeffer, M.D.; Joseph F. Fitzgerald, M.D.; Jean P. Molleston, M.D.; Joseph M. Croffie, M.D.; Marian D. Pfefferkorn, M.D.; Mark R. Corkins, M.D.; Joel D. Lim, M.D.; and Steven J. Steiner, M.D., all of the IU School of Medicine’s Department of Pediatrics and Riley Hospital for Children’s Division of Pediatric Gastroenterology.

Clinical Gastroenterology and Hepatology 2008;6:165–173

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