The Use of an Interdisciplinary Team to Treat Eosinophilic Esophagitis (eoe) in a Pediatric Patient

Eosinophilic Esophagitis (EoE) is an allergic inflammatory condition of the esophagus, recently becoming more widely known. An interdisciplinary approach to treatment can improve outcomes for these patients. Here we present a case where this approach was used to treat a pediatric patient with EoE who was found to have multiple food allergies, gastrointestinal (GI) disease, failure to thrive, feeding disorder and anxiety. An interdisciplinary approach to treatment of EoE in a pediatric patient. 10 year old female presented with frequent abdominal pain, poor weight gain, and reported history of multiple food allergies. A pathological diagnosis of EoE was made and treatment with swallowed glucocorticoids was initiated. Initial improvement was seen on follow up histology. However, symptomatically she worsened and experienced a decline in growth and nutritional status. Allergy work up revealed multiple food allergies that may have been contributing to the worsening EoE and GI symptoms. Achieving dietary compliance was difficult due to the number of foods being eliminated (allergy and empirical elimination), presence of pediatric feeding disorder, anxiety, and other psychosocial stressors. Extensive patient and family education, personalized nutritional counseling and frequent follow up with all disciplines was needed as treatment was implemented. Close collaboration of the interdisciplinary team was instrumental in providing support to the patient and family that ultimately facilitated improvement in symptoms including weight and nutrition while decreasing abdominal symptoms and anxiety.