Please select the eligibility criteria that correspond to the clinical trial below.
Title: Topical Budesonide Treatment for Eosinophilic Esophagitis (EoE): Esophageal Medication Distribution, Treatment Response, and Effect on the Adrenal Axis.
Brief Summary: The purpose of this study is to conduct a clinical trial of two formulations of budesonide (nebulized/swallowed versus viscous/swallowed) in patients with EoE to determine if medication contact time and distribution in the esophagus relates to treatment response. The investigators will also determine if there is systemic absorption of these topical steroids. The investigators hypothesize that tissue and symptom response will correlate with esophageal medication contact time and distribution, and that significant systemic absorption will not be seen.


Options:
A: Inclusion Criteria:

* Males and Females, age 11-40
* Histologic evidence of EoE
* History of clinical symptoms of EoE including dysphagia
* Willing to continue with dietary, environmental or medical therapy
* Ability to read and understand english
* Written Consent

Exclusion Criteria:

* Any Medical condition that may compromise the safety of the subjects or interfere with the signs and symptoms of EoE
* Use of immunomodulatory therapy
* Current use of swallowed corticosteroids
* Esophageal strictures,varices or upper GI bleed
* Other current diseases of the GI tract
* Current viral infection or immunodeficiency condition
* Pregnancy
* Hypersensitivity to budesonide
* History of non compliance
B: Inclusion Criteria:

* Histologic evidence of EoE
* Clinical symptoms of EoE including dysphagia

Exclusion Criteria:

* Primary causes of esophageal eosinophilia other than EoE
C: Inclusion Criteria:

* Patients aged 18-80 with EE, defined as: a) dysphagia, food impaction or other upper gastrointestinal symptoms (chest pain, heartburn, regurgitation); b) multiple esophageal rings or furrows; c) the presence of \>20 eosinophils/high power field in the squamous epithelium or deeper tissues of the esophagus
* Ability to undergo esophageal manometry and ambulatory pH monitoring
* No history of bleeding diathesis, significant cardiopulmonary disease, or other contraindication to upper endoscopy
* Those who have had a one month holiday from either esomeprazole therapy or fluticasone if they have been prescribed this prior to enrollment

Exclusion Criteria:

* Contraindication to proton pump inhibitors or swallowed fluticasone
* Need for immediate esophageal dilation at enrollment due to food impaction at the discretion of the performing endoscopist
* Inability to pass endoscope
* Pregnancy
* Incarceration
* Inability to provide informed consent
* History of esophago-gastric surgery or prior history of abdominal surgery with subsequent strictures or symptoms of obstruction such as abdominal pain and bloating
* Presence of other esophageal pathology that could account for patients' symptoms as determined by histological interpretation by the pathologist
* History of esophageal spasm resulting in trouble swallowing foods larger than 1 cm in diameter
D: Inclusion Criteria:

* New diagnosis of eosinophilic esophagitis (per 2007 consensus guidelines)

Exclusion Criteria:

* Age \< 18
* Inability to read or understand English
* Pregnant or nursing women
* Previous allergic reactions to steroid medications
* Current use of systemic steroids

Answer: D