Annenberg Center for Health Sciences

A 48-year-old man with a 5-year history of gastroesophageal reflux disease is diagnosed with eosinophilic esophagitis after an endoscopy with biopsy for an episode of esophageal food impaction. The patient also has a history of hypertension and hyperlipidemia. His medications include pantoprazole, hydrochlorothiazide, and simvastatin.

Which one of the following would be the most appropriate management for this patient?

Continue pantoprazole and schedule esophageal dilation.
Discontinue pantoprazole, start an elimination diet, and schedule esophageal dilation.
Continue pantoprazole and start an elimination diet and swallowed topical corticosteroid therapy.
Discontinue pantoprazole and start an elimination diet and swallowed topical corticosteroid therapy.

A patient with a 5-year history of EoE is being seen a few days after treatment in the ED for a food impaction. This was his second ED visit in 7 months for a food impaction. His current treatment is topical budesonide, although he admits to not taking his medication regularly. He states that he prefers to adapt his eating behaviors to reduce his risk of food impaction.

What is the next best step in managing this patient with EoE?

Esophageal dilation should be arranged because he has persistent dysphagia despite treatment.
Add pantoprazole because he has persistent dysphagia despite treatment.
Reinforce education about techniques he should use while eating to minimize the risk of food impaction.
Discuss with the patient the optimal therapy to increase treatment adherence.

Which one of the following would be the most appropriate management for this patient?

A: Continue pantoprazole and schedule esophageal dilation.
B: Discontinue pantoprazole, start an elimination diet, and schedule esophageal dilation.
C: Continue pantoprazole and start an elimination diet and swallowed topical corticosteroid therapy.
D: Discontinue pantoprazole and start an elimination diet and swallowed topical corticosteroid therapy.

What is the next best step in managing this patient with EoE?

A: Esophageal dilation should be arranged because he has persistent dysphagia despite treatment.
B: Add pantoprazole because he has persistent dysphagia despite treatment.
C: Reinforce education about techniques he should use while eating to minimize the risk of food impaction.
D: Discuss with the patient the optimal therapy to increase treatment adherence.

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