New therapeutic alternatives are aimed at eliminating eosinophils and reducing inflammation of the esophagus.
By: Luisa Ochoa
The increased presence of eosinophils is one of the most frequent presentations of the esophagitis eosinophilica chronic and autoimmune condition that causes narrowing, difficulty swallowing and inflammation in the esophagus of patients.
The exact cause of this condition is not known, however, it is estimated that genetic, environmental, and immunological factors may play a role, leading to the triggering or worsening of the symptoms of the condition. esophagitis.
Regarding the subject, Dr. Ginés Martínez, gastroenterologist and director of the Oncological Interventional Endoscopy Unit of the Hospital del Centro Comprehensive Cancer, addressed the management of this condition and announced the new treatments recently developed for the benefit of patients.
“One of the presentations that we can have is that the patient has dysphagia or non-cardiac chest pain. This condition is very particular, but the fact of having an increase in eosinophils in the esophagus is what gives us the key to making the diagnosis”, stated the specialist.
Classification of eosinophilic esophagitis
The gastroenterologist mentioned that the condition of esophagitis eosinophilic It is classified into 3 stages: type 1 is mild, type 2 is the most classic presentation, with a higher degree of inflammation, and type 3 is more severe, where chronic narrowing of the esophagus can even be observed.
To treat this condition, it is necessary to take into account three key components: the first, hypoallergenic food, second, identification of the factors that cause allergies, and third, medication with permanent medical monitoring.
In this regard, Dr. Ginés Martínez commented that, “once this condition is diagnosed, you have to live with it, obviously if you follow the treatment you can achieve remission. Patients improve dramatically and return to their normal state once more.
“First, the diet is important, a hypoallergenic diet, we are going to eliminate gluten, peanuts, nuts, lactose, crustaceans, fish, everything that can cause allergies”, emphasized the expert in an interview for the Medicine Magazine and Public Health.
Oral and Injectable Treatments for Esophagitis
Among the drugs available for esophagitis eosinophilic there are proton pump inhibitors or better known as antacids, and there are also steroids such as fluticasone or budesonide.
However, Dr. Martínez delved into the latest treatments developed for the condition.
“More recently, monoclonal antibodies have been approved, which is Dupilumab, which is a monoclonal antibody directed specifically to these cells, to these eosinophils to improve inflammation and eliminate them. This is one of the latest approved new therapies for this condition,” he stated.
In addition, he explained the consequences that patients can face if they are not treated properly.
“Patients who are not being treated might develop narrowing problems in the esophagus, they may even have a spontaneous perforation of the esophagus and it is a serious complication, it can cost them their lives,” he added.
Additional care for patients with eosinophilic esophagitis
Being a disease that has an allergenic and immunological component, the specialist emphasized the importance of following medical treatment and other recommendations provided for patients according to each particular case.
“Among the additional recommendations we suggest not eating at night, eating early; raise the head of the bed, but not with pillows; follow the diet; initially use steroids and if it is a severe case, use Dupixent”, concluded Dr. Martínez.
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