Randomized head-to-head trial of proton pump inhibitor (PPI) vs topical corticosteroids (TCs) post food bolus impaction and/or for untreated patients with Eosinophilic esophagitis (EoE).

Eosinophilic oesophagitis (EoE) is a chronic inflammatory condition of the oesophagus (food pipe) where immune cells called eosinophils build up, causing the oesophagus to narrow. This leads to difficulty swallowing and episodes where food gets stuck. Two main types of medication are used first-line: proton pump inhibitors (PPIs, such as pantoprazole) and topical corticosteroids (TCs, such as Jorveza). Both have evidence behind them, but it is unclear which works better. This study is a randomised controlled trial directly comparing PPI versus topical corticosteroids in adults with EoE, using detailed symptom questionnaires, endoscopy results, biopsy findings, and oesophageal pressure measurements to see which treatment is superior. You may be eligible if you are 18 or older, have been diagnosed with EoE (confirmed by biopsy showing elevated eosinophils), and presented with food bolus obstruction or swallowing difficulties. You may need to stop current EoE treatment for 8 weeks before joining. People with other causes of oesophageal eosinophilia, intellectual disabilities, or who are pregnant would not be eligible.