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Gastroenterology (Expert Forum)
Maybe EE, maybe not... more questions
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Maybe EE, maybe not... more questions
by Hamka, Apr 16, 2005 12:00AM
My biopsies have returned as being "just" esophagitis-- too few eosinophils to be EE. However, the gastroenterologist remarked that the endoscopy looked to him as if it were EE.
I was so miserable last Wednesday that I dragged myself out to the drugstore, purchased Claritin and cromolyn sodium, and began dosing myself. I immediately noticed a difference for the better (able to get down more than 1000 calories of soft/liquid food instead of 500-700; less nausea, some improvement in digestive motility). I also changed myself back to Prevacid (which admittedly I had not been taking regularly for perhaps 11/2 years) because I believed that Protonix was making me sicker.
I asked the gastroenterologist to give me Flovent (or Gastrocrom), but he wants me to swallow the cromolyn spray that I purchased and "see how [I] do over the next 3-4 weeks." He stated that whether this is EE or reflux esophagitis, it should get slowly but steadily better. Is this indeed the case? Should I be taking Gastrocrom? Would it be excessively dangerous to obtain Flonase from another physician (if possible) and begin using it? Is it true that the horrors described (mostly by parents of young children)in the EE/EG Yahoo group postings I read refer to a "completely different disorder"?
I was so miserable last Wednesday that I dragged myself out to the drugstore, purchased Claritin and cromolyn sodium, and began dosing myself. I immediately noticed a difference for the better (able to get down more than 1000 calories of soft/liquid food instead of 500-700; less nausea, some improvement in digestive motility). I also changed myself back to Prevacid (which admittedly I had not been taking regularly for perhaps 11/2 years) because I believed that Protonix was making me sicker.
I asked the gastroenterologist to give me Flovent (or Gastrocrom), but he wants me to swallow the cromolyn spray that I purchased and "see how [I] do over the next 3-4 weeks." He stated that whether this is EE or reflux esophagitis, it should get slowly but steadily better. Is this indeed the case? Should I be taking Gastrocrom? Would it be excessively dangerous to obtain Flonase from another physician (if possible) and begin using it? Is it true that the horrors described (mostly by parents of young children)in the EE/EG Yahoo group postings I read refer to a "completely different disorder"?
Doctor's Answer
by Kevin Pho, MD, Apr 16, 2005 12:00AM
, Apr 16, 2005 12:00AM
It is true that eosinophilic esophagitis and esophagitis from reflux have different treatments. The diagnosis is made via biopsy up and down the esophagus.
Swallowed Flovent is normally the initial treatment if eosinophilic esophagitis is suspected. It is not clear whether acid-suppression (i.e. Prevacid) can help in these cases.
There are small studies suggesting improvement in those who take Cromolyn, and this can be considered if the Flovent isn't working.
If the diagnosis for EE is negative (i.e. via biopsy), you can consider a 24-hr pH study to give a more definitive diagnosis for GERD.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Swallowed Flovent is normally the initial treatment if eosinophilic esophagitis is suspected. It is not clear whether acid-suppression (i.e. Prevacid) can help in these cases.
There are small studies suggesting improvement in those who take Cromolyn, and this can be considered if the Flovent isn't working.
If the diagnosis for EE is negative (i.e. via biopsy), you can consider a 24-hr pH study to give a more definitive diagnosis for GERD.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
