This study will use unsedated (not put to sleep) transnasal endoscopy (TNE) to learn more about how long it takes esophageal eosinophils to come back after either a new food is started or swallowed topical steroid therapy is removed in children with Eosinophilic Esophagitis (EoE). Children in this study will have eliminated one to four foods as treatment for their EoE and will not be taking steroid therapy OR will be taking swallowed topical steroids with any number of foods eliminated.
Eosinophilic Esophagitis (EoE) is a common (1/10,000 individuals) inflammatory disease of the esophagus (the tube- leading from the mouth to the stomach) that is typically caused by exposure to certain substances in food. In this study, participants will be starting a single food introduction or stopping their swallowed topical steroid therapy so that we can learn more about how long it takes EoE to come back after stopping their swallowed topical steroid therapy or introducing a potential food that would cause EoE. We also want to learn more about Unsedated Transnasal Esophagoscopy (TNE). TNE is a way to do an endoscopy to look at the health of the esophagus, without needing to give patients medication that makes them sleepy. TNE also uses a tube through the nose rather than through the mouth, as is done in a traditional sedated oral endoscopy.
The research questions are:
This study is a prospective study that will include 30 children between the ages of 5-22 on dietary elimination therapy (four or less foods) for EoE and not on swallowed or oral steroids OR is on swallowed topical steroid therapy with any number of foods eliminated from the diet. The child with EoE needs to be in clinical remission, meaning that he or she should have less than 15 eosinophils on his/her previous esophageal biopsy.
When the participant’s regular physician determines it is time to reintroduce a food to see if it was an EoE trigger food or remove the swallowed topical steroid therapy, and the family would like to participate, each child and their family will be asked to answer questions regarding their diet, age, and symptoms.
After introducing the new food or stopping swallowed topical steroid treatment, the child will undergo a TNE at 2 and 4 weeks to evaluate the health of his/her esophagus. 6 weeks after starting the new food or stopping swallowed topical steroid therapy (as a child usually does), the child will choose to undergo either a standard sedated endoscopy or one final TNE. After completing the study the child and his/her family will be interviewed about their experience.
For each visit more specifically, you will be asked to:
To be eligible to participate, you must:
You are not eligible to participate if: