He Has EoE: Budesonide

Wednesday, August 4, 2010

A Half a Dose Doesn't Quite Cut It

Last week, we were giving Oliver just a half of a dose of his budesonide slurry. At first, it was hard to tell if he was doing okay with just that little bit. He seemed a bit irritable, but he's a baby so that could be due to many things and not just the lack of medicine. On Friday night it was pretty clear that he was not happy and then he vomited a lot. Saturday wasn't much better, and we wished it wasn't the weekend so that we could call the doctor! He was refusing his bottle and not really eating much else either. We were getting him to drink water, though.

On Monday night, the nurse returned our call from earlier that day. She just left a message because we weren't home and wasn't much help. We finally spoke to the GI and he wants to give Oliver flovent. According to him, it will be sort of a step in between the budesonide and nothing. So, just a way to wean him off medicines a bit more gently.

Wednesday, June 16, 2010

Going to the Allergist

Yesterday was our first post-diagnosis visit to the allergist (to any doctor, actually). We are not sure how much we really like this doctor, but he seems to be fairly knowledgeable about EoE and I feel like he genuinely cares about Oliver. He suggested we use swallowed budesonide (normally an asthma medicine that is inhaled). This would help get rid of the eosinophils in Oliver's esophagus and hopefully eliminate any pain he is feeling and thus allow him to eat and gain weight! He cautioned us that this isn't a cure, simply a band-aid of sorts. Initially, he had us using a nebulizer to administer it, but this morning he called us to tell us about the budesonide slurry a mixture of budesonide and splenda that the child drinks. We may have to try that if Oliver continues to refuse to sit still for the nebulizer. I am just concerned that he may not willingly drink the slurry.

He also sent us for a few more RAST tests to see if we should be eliminating more foods. He really wants us to see a nutritionist and thinks that elemental formula may be in our future.

Who is he?

He is Oliver and he is three years old. Oliver was diagnosed with EoE two weeks after his first birthday. He was diagnosed as failure to thrive at nine months old at which point we pursued some blood tests. His celiac panel came back somewhat positive so we were referred to a pediatric gastroenterologist. We met with the GI on Oliver's first birthday at which point we scheduled an endoscopy to find out exactly what was going on. The endoscopy showed no signs of celiac, but instead a multitude of eosinophils in his esophagus. So celiac was ruled out and Eosinophilic Esophagitis became his new diagnosis.

What is EoE?

An eosinophil is a white blood cell that is an important part of the immune system, just not when found in large numbers in one's esophagus! Eosinophilic Esophagitis (EoE) is the result of an abnormal amount of eosinophils in the esophagus. These eosinophils are often caused by food protein and the eosinophils cause inflammation in the esophagus. Treatment options are dietary management (removal of trigger foods) and topical corticosteroid treatment. The steroids control the inflammation in the esophagus and suppress the eosinophils, but once treatment stops, the eosinophils will return unless the trigger foods are all removed.