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For most people, an insect sting means a little pain and discomfort. But some people may have trouble breathing or itch and have hives all over their body after being stung. These people are allergic to insect stings. This means that their immune system overreacts to the insect’s venom. Most allergic insect sting reactions are caused by five kinds of insects:   Yellow jackets   Honeybees   Paper wasps   Hornets   Fire ants For people who are very allergic to an insect’s venom, a sting may cause a dangerous allergic reaction called anaphylaxis (an-a-fi-LAK-sis). Signs of anaphylaxis include:   Itching and hives over a large part of the body   Swollen throat or tongue   Trouble breathing   Dizziness   Stomach cramps   Nausea or upset stomach   Diarrhea If you are allergic to insect stings, you can reduce your risk of having an allergic reaction by staying indoors during insect season and always carrying autoinjectable epinephrine. You can also talk to your allergist/immunologist about receiving immunotherapy, which can protect you the next time you are stung by an insect. Insect sting allergy can be severe, leading to a systemic reaction called anaphylaxis. In addition, after being stung, some individuals experience other symptoms. They include: Anaphyalaxis For a small number of people with severe venom allergy, stings may be life-threatening. Severe allergic reactions to insect stings can involve many body organs and may develop rapidly. This reaction is called anaphylaxis. Symptoms of anaphylaxis may include itching and hives over large areas of the body, swelling in the throat or tongue, difficulty breathing, dizziness, stomach cramps, nausea or diarrhea. In severe cases, a rapid fall in blood pressure may result in shock and loss of consciousness. Anaphylaxis is a medical emergency, and may be fatal. Toxic reaction A toxic reaction can cause symptoms similar to those of an allergic reaction, including nausea, fever, swelling at the site of the sting, fainting, seizures, shock, and even death. A toxic reaction occurs when the insect venom acts like a poison in the body and may result after only one sting, but it usually takes many stings from insects that are not normally considered poisonous. Serum sickness Serum sickness is an unusual reaction to a foreign substance in the body that can cause symptoms hours or days after the sting. Symptoms include fever, joint pain, other flulike symptoms, and sometimes hives.

Infection occurs when a disease-causing germ such as a bacteria, virus or fungus invades the body. To become infected, you must catch the germ (exposure) and have the ability to become infected (susceptibility). Susceptibility is more complicated than exposure. We are all susceptible to infection by thousands of different germs. The purpose of the immune system is to prevent infection by recognizing germs and eliminating or disabling them before they can cause infection.  People with immunodeficiency get the same kinds of infections that other people get—ear infections, sinusitis and pneumonia. The difference is that their infections occur more frequently, are often more severe, and have a greater risk of complications.  We live in a sea of germs, and everyone gets an infection at least once in a while. However, while most people can recover on their own from most infections, some people experience recurring infections that require antibiotic treatment.   Exposure and susceptibility to infections   Infection occurs when a disease-causing germ, such as a bacteria, virus or fungus, invades the body. To become infected, you must catch the germ (exposure) and have the ability to become infected (susceptibility). People with a lot of contact with others, such as elementary school teachers or salespersons, are more likely to be exposed to increased numbers of germs.  Susceptibility is more complicated than exposure. We are all susceptible to infection by thousands of different germs. The purpose of the immune system is to prevent infection by recognizing germs and eliminating or disabling them before they can cause infection. Remarkably, the immune system has the unique ability to learn the “face” of a germ and remember it forever. Some germ families have faces that are so similar that when your immune system learns the face of one member of the family, it protects you from infection by any member of that family. Other germ families are so different that the immune system must learn each face individually. Once your immune system has learned the face of a particular germ and successfully battled it, you are much less susceptible to infection caused by that germ.  The first line of defense against infection is located where the body has contact with the rest of the world—the skin—as well as the membranes that line the respiratory system and digestive systems. Clearly, a cut on the hand is more likely to get infected than unbroken skin. Similarly, irritation, swelling and injury to the mucus membranes lining the nose, sinuses and lungs provide a fertile ground for disease-causing germs. If you have year-round allergies to dust mites, pollen and mold, you may have some injury to your mucus membranes, which can, in turn, increase your susceptibility to infection. Once a germ has entered the body, your immune system springs into action.  Common infections  The most common infections are viral respiratory tract infections—colds. Typically, cold symptoms last five to 10 days. If a child gets 12 colds a year, each lasting less than 10 days and usually improving without needing treatment with antibiotics, there is not usually a cause for concern. It may seem, however, that the child is sick half the time—because he or she is! These viral infections are a result of the close contact that young children have with other infected children and the fact that their immune systems are relatively immature. Once a child’s immune system learns the faces of many of the germs that cause such colds, the child will get infected less frequently.  Another infection, strep throat, is also a “social disease” that children and adults catch because they are in close contact with infected individuals. Although we don’t completely understand why some people get strep throat frequently, we know that recurrent strep throat is rarely an indicator of a weak immune system.  Many people confuse allergic rhinitis, or “hay fever,” which causes stuffiness, nasal itch and a runny nose that lasts for weeks, with a cold or sinus infection. Your allergist/immunologist can help you differentiate allergies from infection, or know when both are present at the same time. Once the possibility of allergy is eliminated, your allergist will consider if your infections are a simply a result of high exposure to other people with infections, or if these infections are warning signals of an immune system problem called immunodeficiency . There are many forms of immunodeficiency and while some are very severe and life-threatening, many are milder but still important enough to cause recurrent or severe infections. Signs of Immunodeficiency  People with immunodeficiency get the same kinds of infections that other people get—ear infections, sinusitis and pneumonia. The difference is that their infections occur more frequently, are often more severe, and have a greater risk of complications. Furthermore, the infections usually do not go away without using antibiotics and often recur within one to two weeks after antibiotic treatment is completed. These patients frequently need many courses of antibiotics each year to stay healthy. Patients with some forms of immunodeficiency are more likely than other people to develop infections inside certain areas of the body, such as the bones, joints, liver, heart or brain.  In most cases, the frequency of infection is the most important issue, but sometimes a single infection with an unusual germ is enough to trigger the need for the doctor to perform a thorough immunologic evaluation of the patient.  So, how many infections are too many? Allergist/immunologists often use the frequency of the use of antibiotics to mark the frequency of significant infections. Older children and adults with healthy immune systems seldom require antibiotic treatment. However, for the reasons mentioned above, many younger children receive several courses of antibiotic therapy each year. Therefore, the number of ear infections that may be “normal” in a child under 5 years of age is clearly abnormal in older children and adults. General guidelines for determining if a patient may be experiencing too many infections are: The need for more than four courses of antibiotic treatment per year in children or more

Millions of people suffer from seasonal allergy symptoms such as congestion, an itchy, runny nose and itchy, watery eyes. However, many also suffer from perennial allergies, which result in symptoms throughout the year. Perennial allergies are triggered by indoor allergens, including house dust mite droppings, animal dander, cockroach droppings and indoor molds. Learn more about managing your allergy symptoms caused by indoor allergens by reading the resources listed below. Millions suffer allergy symptoms caused by indoor allergens such as dust mite droppings, animal dander, cockroach droppings and molds. While it is impossible to avoid these allergens, there are ways you can minimize exposure to them. Controlling Dust Mites Who could guess that a microscopic-sized allergen could cause major problems? • Dust mite allergens are found throughout the house, but thrive in bedding and soft furnishings. • Because so much time is spent in the bedroom, it is essential to reduce mite levels there. Encase mattresses, box springs and pillows in special allergen-proof fabric covers or airtight, zippered plastic covers. Bedding should be washed weekly in hot water (130° F) and dried in a hot dryer. • Keep humidity low by using a dehumidifier or air conditioning. • Wall-to-wall carpeting should be removed as much as possible. Throw rugs may be used if they are regularly cleaned. • People with allergies should use a vacuum with a HEPA (highefficiency particulate) filter or a double-layered bag, and wear a dust mask-or ask someone else to vacuum. Controlling Pet Allergens Contrary to popular opinion, people are not allergic to an animal’s hair, but to an allergen found in the saliva, dander (dead skin flakes) or urine of an animal with fur. • All dogs and cats carry these proteins, so no breed is allergy-free. • If you cannot avoid exposure, try to minimize contact and keep the pet out of the bedroom and other rooms where you spend a great deal of time. • As with dust mites, vacuum carpets often or replace carpet with a hardwood floor, tile or linoleum Controlling Cockroaches An allergen in cockroach droppings is a main trigger of asthma symptoms. • Block all areas where roaches could enter your home, including crevices, wall cracks and windows. Cockroaches need water to survive, so fix and seal all leaky faucets and pipes. Have an exterminator go through the house to eliminate any remaining roaches. • Keep food covered and put pet food dishes away after pets are done eating. Vacuum and sweep the floor after meals, and take out garbage and recyclables. Use lidded garbage containers in the kitchen. Wash dishes after use and clean under stoves, refrigerators or toasters where crumbs can accumulate. Wipe off the stove and other kitchen surfaces and cupboards regularly. Controlling Indoor Molds • Indoor molds and mildew need dampness, such as found in basements, bathrooms or anywhere with leaks. Remove mold on hard surfaces with water, detergent and 5% bleach (do not mix with other cleaners). For clothing, wash with soap and water. • Repair and seal leaking roofs or pipes. Use a dehumidifier in damp basements, but empty the water and clean units regularly to prevent mildew from forming. Don’t carpet concrete or damp floors, and avoid storing items in damp areas.

Hypereosinophilic syndrome (HES) is a rare disorder in which an individual’s blood contains very high numbers of eosinophils, a type of white blood cell that play an important role in the immune system.  Most people have less than 500/microliter of eosinophils in their blood. HES patients usually have more than 1500 eosinophils/microliter in the blood over a long period (more than 6 months) – without an identifiable cause. These eosinophils infiltrate the tissues, causing inflammation and eventually organ dysfunction. The most commonly involved organs in HES include the skin, lungs, heart and the nervous system.  Symptoms  HES can happen at any age, although it is more common in adults. There is great variability in the symptoms of HES. Skin rashes are common and include urticaria (hives), angioedema (swelling) or other types of bumpy rash. The heart may be involved, with or without symptoms. Neurologic symptoms may include changes in behavior, confusion, loss of balance, dizziness, memory loss, or abnormal sensations of pain or numbness. Other less common symptoms include cough, shortness of breath, fatigue, fever and itching. Mouth ulcers, visual symptoms and enlargement of the liver and/or spleen may occur. HES patients are at risk for clots in their blood vessels and may have “mini” or major strokes. Disease Types  HES includes a collection of syndromes. The myeloproliferative type of HES is associated with an acquired genetic problem (FIP1L1-PDGFRA)that causes eosinophils and other blood cells to grow in a manner similar to leukemia. Genetic testing is performed to identify patients with this HES variant as they may respond favorably to treatment with certain cancer drugs such as imatinib mesylate. Diagnosis  There is no specific diagnostic test for HES. The first step is to investigate for other conditions that can cause eosinophilia.These conditions include parasitic infection, allergic disease, cancers, autoimmune diseases and drug reactions.  Testing is individualized according to symptoms and may include stool evaluation to detect parasitic infection, allergy testing to diagnose environmental or food allergies, biopsies of the skin or other organs or blood tests to screen for autoimmunity and radiologic imaging of affected organs. An allergist/immunologist has specialized training to to effectively diagnose the problem, and if HES is present to work collaboratively with other specialists such as a Hematologist or Cardiologist in the treatment and monitoring of HES patients. When diagnosed with HES, it is important to determine the extent of organ damage. A chest x-ray and echocardiogram are routinely performed to evaluate the heart and lungs. Other tests often performed in HES patients include liver and kidney function, serum vitamin B12 levels, erythrocyte sedimentation rate (ESR) and serum tryptase levels.  Treatment  The goal of HES treatment is to reduce eosinophil levels in the blood and tissues, thereby preventing tissue damage–especially in the heart. Standard HES treatment has included glucocorticosteroid medications such as prednisone, and chemotherapeutic agents such as hydroxyurea, chlorambucil, and vincristine. Side effects occur frequently with these medications that are usually required for long-term use.  Interferon-alpha has also been used as a treatment. This medication must be administered by frequent injections and causes potent side effects such as fatigue and influenza-like symptoms.  Research is uncovering new treatment therapies for HES. One new approach for controlling malignant cell growth is the use of tyrosine kinase inhibitors such as Gleevac. Other tyrosine kinase inhibitors currently under study include Dasatinab and Nilotinib. Monoclonal antibody therapy has also shown promise for treatment of HES. A 2008 clinical trial showed that once monthly intravenous anti-IL-5 (Mepolizumab) allowed for lower doses of oral steroids in HES patients that were studied for 9 months.  Prognosis  The prognosis of HES depends upon the extent of any organ damage. In very severe cases, HES may be fatal, but there is hope. Survival rates have improved greatly. In 1975, only 12% of HES patients survived three years. Today, more than 80% of HES patients survive five years or more.

Urticaria, also called hives, are red, itchy, swollen areas of the skin that can range in size and appear anywhere on the body. The blotches can migrate on body, appearing in different areas throughout the course of the reaction. Usually, the cause of urticaria is readily identifiable—often a viral infection, or allergic reaction to drugs, food or latex. These hives usually go away spontaneously or by avoiding the allergic trigger. However, in some cases, medical intervention is needed to increase comfort or prevent recurrence. Treatment with oral antihistamines is frequently successful, but in severe cases, steroids may be needed. Some people have chronic urticaria that occurs almost daily for months or, in some cases, years. For these individuals, scratching, pressure or stress may aggravate hives. An allergist/immunologist can diagnosis the problem and prescribe treatments for this bothersome condition.

The novel H1N1 flu virus (sometimes called “swine flu”) created headlines around the world. As with the regular, seasonal flu, people with allergies and asthma should take prevention measures to avoid getting sick.  The vaccine for the seasonal flu/ H1N1 is among the best prevention tool available to prevent complications from the flu. However, Individuals with egg allergy may be at risk for an allergic reaction to H1N1 and seasonal influenza vaccines due to the egg content in the vaccine preparations. Before getting vaccinated, consult with your health care provider.  The novel H1N1 flu virus (sometimes called “swine flu”) is creating headlines around the world. With each passing day, medical experts and the public are learning more about this virus – how it behaves and how to treat it.  As with the regular, seasonal flu, people with allergies and asthma should take prevention measures to avoid getting sick.  EFFECT OF ASTHMA A recent report from the Centers for Disease Control and Prevention (CDC) found that the majority of pediatric deaths from H1N1 occurred in children with an underlying medical condition–in some cases asthma.  Children and adults with respiratory conditions such as asthma are more likely to experience serious health problems if they contract the flu. The American Academy of Allergy, Asthma & Immunology (AAAAI) urges all patients with asthma to get the flu/H1N1 vaccine.    IS IT AN ALLERGY OR IS IT THE FLU?  Novel H1N1 and the seasonal flu are not the same, but have similar symptoms. Some allergy symptoms may also be confused for flu symptoms. For parents of children with asthma or allergies, telling the difference between allergic disease symptoms and the seasonal flu or H1N1 may be a bit difficult.  “Itchy eyes, a scratchy nose or sneezing are symptoms of allergies,” explains Thomas B. Casale, MD, FAAAAI. “But if your child suffers from asthma and develops a fever or nausea and vomiting, consult your physician.”  Here’s how to tell if you are suffering from allergies or something more severe  Allergy symptoms Runny nose Sneezing Stuffiness Itchy, watery eyes Itchiness in the nose, mouth or throat  Flu symptoms  Runny nose Coughing Sore throat Tiredness Lack of appetite Fever Nausea or vomiting Diarrhea  FOOD ALLERGIES AND VACCINES  Vaccinations for both the seasonal flu and H1N1 are among the best prevention tools available to prevent complications from the flu. But what if you are allergic to a substance in the vaccines?  “Individuals with egg allergy may be at risk for an allergic reaction to H1N1 and seasonal influenza vaccines due to the egg content in the vaccine preparations,” reports Dr. Casale. “Before getting vaccinated, review the information posted on www.aaaai.org and consult with your health care provider. In most cases, vaccination can be tolerated if done according to these recommendations.”  IF YOU DO GET SICK The Centers for Disease Control and Prevention recommends that people with flu-like symptoms stay home for at least 24 hours after they are free of fever.  If you experience severe symptoms, including difficulty breathing, chest pain/pressure, dizziness or persistent vomiting, seek emergency medical care.

People with food allergies have an allergic reaction when they come in contact with certain foods. This happens because their immune system overreacts to the proteins in that food. Eight kinds of food cause most food allergies:      Cow’s milk     Eggs     Peanuts     Wheat     Soy     Fish     Shellfish     Tree nuts  Signs of a food allergy include:     A rash, or red, itchy skin     Stuffy or itchy nose, sneezing, or itchy and teary eyes     Vomiting, stomach cramps or diarrhea     Angioedema or swelling  Some people with food allergies can have a serious reaction called anaphylaxis. Signs of this kind of reaction include:     Hoarseness, throat tightness or a lump in the throat     Wheezing, chest tightness or trouble breathing     Tingling in the hands or feet, lips or scalp

Allergic conjunctivitis is the most common allergy affecting the eyes. The conjunctivae—the thin membranes covering the eyelids and the exposed surface of the eyes—is an active tissue of the immune system that responds to allergies caused by airborne particles, or allergens. Allergic conjunctivitis can appear in two forms: seasonal and perennial. The seasonal version is much more common, and is related to exposure to specific airborne allergens, such as grass, tree and weed pollens and molds. The perennial form persists throughout the year and is usually triggered by dust mites, animal dander and feathers. EYE ALLERGY: CAUSES AND TREATMENT Conjunctivitis is an inflammation of the conjunctiva. This is the mucous membrane covering the white of the eyes and the inner side of the eyelids. If something irritates this clear membrane, your eyes may water, itch, hurt, or become red or swollen. In some people, conjunctivitis is due to an allergy. In these instances, the condition is called either allergic conjunctivitis or ocular allergy. It can occur alone, or it may be associated with nasal allergy symptoms. Unlike conditions such as pink eye, allergic conjunctivitis is not contagious. A recent study reported by Leonard Bielory, MD, FAAAAI, states that ocular allergies may be more common than nasal allergies in some areas, especially in the southern United States. And, while most people treat nasal allergy symptoms, they often ignore their itchy, red, watery eyes. CAUSES AND TRIGGERS If you have an allergy, your immune system identifies something as an invader or allergen. Your immune system overreacts by producing antibodies called Immunoglobulin E (IgE). These antibodies travel to cells that release chemicals, causing an allergic reaction. This reaction usually causes symptoms in the nose, lungs, throat, sinuses, intestinal tract or the eyes. The most common allergen is pollen, which is seasonal. People with seasonal allergic conjunctivitis, or rhinoconjuntivitis will experience symptoms at certain times during the year – usually from early spring, into summer, and even into autumn (fall). Those with perennial allergic conjunctivitis are susceptible at any time of year. These irritations may be triggered by perfumes, cosmetics, skin medicines, or environmental allergens such as air pollution or second-hand smoke. SYMPTOMS Most people suffering from allergic conjunctivitis have problems in both eyes. Symptoms may appear quickly, soon after the eyes have come into contact with the allergen. The most common symptom occurs when the eyes become irritated, the capillaries (small blood vessels) widen and the eyes become pink or red. Some people experience pain in one or both eyes. Other symptoms include swollen eyelids, a burning sensation, sore or tender eyes. TREATMENT According to Dr. Bielory, about 50% of conjunctivitis cases seen by primary care physicians are actually allergic in nature. There are many different treatment options, depending upon the severity of the symptoms. As with any allergy, the first approach for successful management of seasonal or perennial forms of eye allergy should be prevention or avoidance of the allergens that trigger your symptoms. The AAAAI Outdoor Allergens brochure offers tips on avoiding triggers. However, avoidance of airborne allergens isn’t always possible. That is when medications may be helpful. Over-the-counter (OTC) eye drops and oral medications are commonly used for short-term relief of some eye allergy symptoms. However, they may not relieve all symptoms, and prolonged use of some OTC eye drops may actually make your symptoms worse. Prescription eye drops and oral medications can also treat eye allergies. Prescription eye drops provide both short- and long-term targeted relief of eye allergy symptoms, and they can be used to manage eye allergy symptoms in conjunction with an oral antihistamine that might be taken to manage nasal allergy symptoms. Any medication placed in the eye should be kept in the refrigerator.

Exercise-Induced Bronchoconstriction (EIB) is a narrowing of the airways causing difficulty moving air out of the lungs. Chronic asthma is an inflammatory disorder. Most patients with chronic asthma will have a flare when they exercise. Other individuals appear to have a flare of asthma only when they exercise and do not otherwise have chronic asthma. Symptoms include coughing, wheezing, tight chest, and prolonged and unexpected shortness of breath after about 6 to 8 minutes of exercise. These symptoms are often even worse in cold, dry air. Warm and humid air may lessen the symptoms. Unfortunately pollens and molds are present at the times of the year when the air is warm and humid and these substances in the air may also trigger attacks of asthma. Exercise-Induced Bronchoconstriction (or EIB) causes symptoms of coughing, wheezing, chest tightness to breathing, or shortness of breath. Children with EIB may experience breathing difficulty 5-20 minutes after exertion begins. EIB may occur more easily on cold, dry days than on warm, humid days. If your child’s asthma is triggered by exercise, the symptoms can take subtle forms. They may complain of not being able to run as fast as their peers, and consequently express a dislike for sports. In school-age children, inferior performance in physical education classes or a reluctance to participate in athletics may also lead to problems with fellow students and teachers and low self-esteem. Without proper diagnosis, EIB may cause children to avoid physical activity altogether, but this does not have to be the case. Although the type and duration of recommended activity varies with each individual, some activities are better for those with EIB. Almost all people with EIB should be able to exercise to their full ability with appropriate diagnosis and treatment. Sports that are less likely to trigger EIB: Swimming Walking Leisure biking Hiking Free downhill skiing Team sports that require short bursts of energy , including: Baseball Football Wrestling Golfing Gymnastics Short-distance track and field events Sports that require continuous activity or are cold weather activities are more likely to trigger EIB: Soccer Basketball Field hockey Long-distance running Cross-country skiing Hockey Make sure your child’s physical education teacher and/or coach has specific written instructions that include: The nature of EIB, Which medications are used to prevent EIB and how to use them, Other techniques to prevent EIB (e.g., warm-up period), Warning signs of an asthma episode

Eosinophilic esophagitis (EE) is an allergic condition characterized by inflammation of the esophagus (the tube that connects the throat with the stomach). People with this disease have a large number of eosinophils, a type of white blood cell, in their esophagus. The majority of individuals with eosinophilic esophagitis have family histories of allergies and symptoms of one or more allergic disorders such as asthma, nasal allergies, atopic dermatitis or food allergy. Diagnosis Other diseases, including acid reflux, can cause eosinophils in the esophagus. Therefore, it is useful to exclude acid reflux as the cause with a trial of acid suppressive medications. Currently, the only way to diagnose eosinophilic esophagitis is with an endoscopy and biopsy of the esophagus. This is typically coordinated between a gastroenterologist and a pathologist. After the diagnosis of eosinophilic esophagitis has been made, an allergist/immunologist, often referred to as an allergist, is the most qualified physician to determine the role of allergies in the condition. An allergist can provide you, your family and your gastroenterologist with a comprehensive evaluation of the allergic components of eosinophilic esophagitis. Eosinophilic Esophagitis and Allergies Allergies are the result of a chain reaction that starts in the immune system. Your immune system controls how your body defends itself. For instance, if you have an allergy to tree nuts, the immune system identifies tree nuts as an invader or allergen. Your immune system overreacts by producing antibodies called Immunoglobulin E (IgE). These antibodies travel to cells that release chemicals, causing an allergic reaction. Food allergy is a major, yet complex, cause of eosinophilic esophagitis in children, and a probable factor in adult eosinophilic esophagitis. Environmental allergies such as dust mites, animals, pollens and molds may also play a role. Testing Allergy skin tests are useful in determining which allergens are triggering your symptoms. With this painless test, a small amount of allergen is put on your skin by making a small scratch or prick on the surface of the skin through a drop of the allergen extract. If a raised bump or small hive develops within 20 minutes, it indicates a possible allergy. If this does not develop, the test is negative. In certain cases, such as severe eczema, an allergy skin test cannot be done and your allergist may recommend a blood test. Another method for testing for food allergies is a challenge. This is done by feeding the food to find if it causes a reaction. Food patch testing is in another type of allergy test that may be used in the evaluation of EE. This test is used to determine whether an individual has delayed reactions to a food. The patch test is done by placing a small amount of fresh food in an aluminum chamber. The food stays in contact with the skin for 48 hours, is removed and the allergist reads the results at 72 hours. Areas of the skin in contact with the food that have become inflamed indicate a delayed reaction to the food. Treatment Elimination Diet Information about specific food allergies obtained from prick, blood and patch testing can be used to determine if specific food groups should be eliminated from your diet. For many people, this is the only treatment that is required to control eosinophilic esophagitis. In some instances, all sources of protein must be removed from the diet. This approach is generally reserved for individuals with multiple food allergies, or who fail to respond to other forms of therapy Medications No medications are currently FDA approved for the treatment of eosinophilic esophagitis. New forms of therapy are under investigation and may provide significant relief in the future. In the meantime, swallowed steroid from an asthma inhaler or nebulizer is being used effectively, under the care of a physician.