What is eosinophilic esophagitis typically treated with?

• A. Diets, proton pump inhibitors for inflammation, and topical swallowed corticosteroids.
• B. Antibiotics and antifungals only.
• C. Surgery is always required.
• D. No treatment is effective.

Answer: (A)

Eosinophilic esophagitis is a chronic, immune-driven inflammation of the esophagus, so treatment focuses on calming that inflammation and removing triggers that provoke it. One main approach is dietary management: identifying and eliminating foods that provoke the esophageal immune response, often through elimination or elemental diets, with careful reintroduction to pinpoint triggers. Another component is proton pump inhibitors, which help reduce inflammation in the esophagus beyond simply lowering stomach acid, and many patients experience symptom and biopsy improvement with PPIs. The third cornerstone is topical swallowed corticosteroids, which coat the esophagus and directly suppress eosinophilic inflammation with minimal systemic effects.

These strategies are used together or sequentially based on how a patient responds, and monitoring with follow-up endoscopy and biopsies guides adjustments. Other options aren’t standard treatments for EoE—antibiotics and antifungals address infections, not the inflammatory process; surgery isn’t a typical or primary therapy; and there are effective treatments, so saying no treatment would be inappropriate.