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EOE by Mind Map: EOE

1. Diagnosis

1.1. Endoscopy

1.1.1. Biopsy

1.1.1.1. Location

1.1.1.1.1. Distal x 4 + 2 from prox

1.1.1.2. Number

1.1.1.2.1. 100% sensitivity for 5-6 bx

1.1.1.2.2. 84% sensitivity for 2 bx

1.1.2. PPI preTx

1.1.2.1. Length of time

1.1.2.2. Dose

1.2. Radiology

1.2.1. Swallow study

1.2.2. Esophagram

1.3. Allergy testing

1.3.1. SPT

1.3.2. Patch

1.3.3. RAST

1.3.4. Observed reactions

1.3.5. Intradermal

2. Treatment

2.1. Corticosteroids

2.1.1. Fluticasone HFA

2.1.1.1. Dose

2.1.1.1.1. Age 1-4: 44 mcg, 2 sprays BID

2.1.1.1.2. Age 5-10: 110 mcg, 2 sprays BID

2.1.1.1.3. Age >11: 220 mcg, 2 sprays BID

2.1.1.2. Step down

2.1.2. Budesonide

2.1.2.1. Age <10 y: 0.5 mg BID

2.1.2.2. Age >10 y: 1 mg BID

2.1.3. Systemic

2.2. PPI

2.2.1. 1 mg/kg/dose BID

2.3. Antigen avoidance

2.3.1. Directed

2.3.2. Six food elimination

2.3.2.1. Reintroduction

2.3.2.1.1. How long before EGD?

2.3.2.1.2. How many proteins to introduce between EGDs?

2.3.2.1.3. More allergenic foods vs less?

2.3.2.1.4. How many days/weeks between new proteins?

2.3.3. Elemental

2.4. Mepolizumab

3. Complications

3.1. Stricture

3.1.1. Dilation first

3.1.2. Medication first

3.2. Perforation

3.3. Fibrosis

4. Future Questions

4.1. Fibrosis in treated patients

4.2. Side effects of swallowed steroids

4.3. Immunotherapy

4.4. Quality of life