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Abstract

Eosinophilic esophagitis is a clinicopathologic disease characterized by upper intestinal symptoms and the finding of more than 15 or 20 eosinophils in the esophageal epithelium. Lack of awareness to EoE among some gastroenterologists made the disease under recognized. Patients with eosinophilic esophagitis should be referred to both an allergist and gastroenterologist for optimal management which may include dietary modifications, pharmacologic agents, ingested fluticasone and its role in EOE will be discussed in this study. This study was conducted at faculty of medicine,Alexandria University, Internal Medicine Department. The study was conducted on twenty patients who were complaining from recurrent dysphagia and done upper GIT endoscopyand diagnosed histopathologically as EOE. The 20 patients was randomly assigned to receive either placebo (n=10) or swallowed fluticasone (n=10). Treatment lasted for four weeks and follow up extended up to 8 months. After 4 weeks treatment, clinical symptoms and histological changes were evaluated. Histologic improvement in the form of full histological remission was seen in seven patients in the fluticasone group compared with one patient who achieved remission in the placebo group. In conclusion, the study highlights the problems of diagnosis and lack of awareness and understanding of the etiology and pathogenesis of the disease. The use of ingested fluticasone showed improvement of symptoms and histological pattern.

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