How Effective are Swallowed Inhaled (topical) Steroids

Swallowed inhaled steroids can be very effective in treating the inflammation associated with eosinophilic esophagitis. Studies have shown that EoE patients on this type of therapy can have complete resolution of their disease, although there are some patients who do not show any benefit from this treatment. A small pediatric study looking at the efficacy of swallowed fluticasone, 50% of patients showed complete healing of biopsies after 3 months of therapy. Interestingly, this EoE study demonstrated that patients with allergic disease, that is with a history of asthma, eczema, or environmental allergies, appeared to have less benefit from swallowed steroids. Even though patients can have resolution of their EoE while on swallowed inhaled steroid therapy, in most cases their disease will return once steroids are discontinued. Therefore, it can be useful to treat and control the disease, but it is not a cure for eosinophilic esophagitis.