Is There a Role for Topical Swallowed Steroids upon Emergency Room Admission for Suspected Food Bolus Obstruction in Eosinophilic Esophagitis?
Philipp Schreiner, Thomas Greuter, Aurora Tatu and 3 others
PMID 34398319WHAT IT FOUND
In eight emergency patients given swallowed budesonide for suspected food bolus obstruction, 38% had the bolus not observed at endoscopy or symptoms resolved before endoscopy.
Five needed endoscopic removal. No control group means this does not prove the steroid worked.
Key findings
01Eight patients were analysed after receiving 1 mg of budesonide immediately after admission.
02In 38% of the treated patients, the bolus was not observed at endoscopy or symptoms resolved so that emergent endoscopy was postponed; endoscopic removal was necessary in five.
03Persistent food bolus obstruction was seen at endoscopy in all three treated patients with a documented stricture or narrow-caliber esophagus.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only eight patients received the tablet, and there was no control group, so the resolution rate cannot be attributed to the tablet alone. Whether the tablet was given was left to the gastroenterologist on duty, so assignment was not random. The authors state that the small sample size and lack of control mean the findings cannot provide robust evidence on efficacy. None had a confirmed EoE diagnosis before endoscopy, so the group was not a known EoE cohort at admission.
Declared interests
Funding was from Universität Zürich; no additional conflicts are stated in the supplied text.
The easy way to misread this
Do not read the 38% resolution rate as proof that swallowed budesonide works for food bolus obstruction. There was no control group, only eight treated patients, and the authors state that the findings cannot provide robust evidence on efficacy.