Jameel Alp , Alyssa M. Bren , Tyson Sievers , Joshua A. Sloan
{"title":"Swallowed Nasal Fluticasone Spray for Eosinophilic Esophagitis: An Affordable and Off-Label Path to Histologic Remission","authors":"Jameel Alp , Alyssa M. Bren , Tyson Sievers , Joshua A. Sloan","doi":"10.1016/j.gastha.2025.100760","DOIUrl":null,"url":null,"abstract":"<div><div>Swallowed topical corticosteroids are among the first-line therapies for eosinophilic esophagitis, with budesonide oral suspension recently approved by the Food and Drug Administration. However, off-label options such as fluticasone from metered-dose inhalers remain widely used due to cost and access barriers. We report a case of histologic remission achieved using over-the-counter fluticasone nasal spray administered orally with honey—an approach not previously described in the literature. This patient-led, low-cost method followed incomplete response to both proton pump inhibitors and fluticasone metered-dose inhaler. The case may illustrate a potential alternative steroid delivery method in eosinophilic esophagitis for resource-conscious, individualized care.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 1","pages":"Article 100760"},"PeriodicalIF":0.0000,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastro hep advances","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2772572325001475","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Swallowed topical corticosteroids are among the first-line therapies for eosinophilic esophagitis, with budesonide oral suspension recently approved by the Food and Drug Administration. However, off-label options such as fluticasone from metered-dose inhalers remain widely used due to cost and access barriers. We report a case of histologic remission achieved using over-the-counter fluticasone nasal spray administered orally with honey—an approach not previously described in the literature. This patient-led, low-cost method followed incomplete response to both proton pump inhibitors and fluticasone metered-dose inhaler. The case may illustrate a potential alternative steroid delivery method in eosinophilic esophagitis for resource-conscious, individualized care.