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Non-surgical interventions for eosinophilic oesophagitis.
R H Kukuruzovic1, E E Elliott, E V O'Loughlin
1Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Flemington Road, Parkville, Melbourne, VIC, Australia, 3052.
The Cochrane Database of Systematic Reviews
|July 22, 2004
Summary
No completed randomized controlled trials (RCTs) exist for eosinophilic esophagitis (EO) treatments. Preliminary data suggests topical fluticasone and oral prednisolone may offer similar benefits for EO symptom relief.
Area of Science:
- Gastroenterology
- Clinical Trials
- Pediatric Gastroenterology
Background:
- Eosinophilic esophagitis (EO) presents with dysphagia, vomiting, and abdominal pain.
- Patients with EO often show poor response to proton pump inhibitors and anti-reflux surgery.
Purpose of the Study:
- To evaluate the benefits and harms of medical interventions for eosinophilic esophagitis.
Main Methods:
- Searched Cochrane Library, MEDLINE, and EMBASE databases up to February 2004.
- Included randomized controlled trials (RCTs) comparing medical/dietary interventions for EO against placebo or other interventions.
- Two reviewers independently screened abstract titles.
Main Results:
- No completed RCTs were identified in the published literature.
- One abstract reported preliminary data from an ongoing RCT comparing oral prednisolone with topical fluticasone in 50 children, showing similar healing and symptom resolution rates.
- Results from another ongoing RCT comparing swallowed fluticasone with placebo are not yet available.
Conclusions:
- The absence of completed RCTs prevents a definitive comparison of medical interventions for EO.
- Published case series suggest potential benefits from elemental diets, oral steroids, and topical steroids.
- Lack of control groups in case series limits the evaluation of intervention effectiveness.