Clarification of Eosinophilic Esophagitis Treatment in the DoD Retention Standards

Abstract

The DoD Instruction 6130.03, Volume 2, outlines the retention standards for the U.S. Military, providing guidance on medical conditions and treatments that are disqualifying for all branches of the military. This document states that patients with conditions requiring immunomodulating or immunosuppressant medications do not meet retention standards. Eosinophilic esophagitis is a common, chronic inflammatory disease of the esophagus that typically presents with dysphagia. Although proton pump inhibitors are effective at treating this disease in some cases, swallowed topical steroids are the most frequently used therapy within the DoD. These medications act locally in the esophagus and do not cause systemic side effects typical of oral steroid therapy, including immunosuppression. They are effective at inducing and maintaining disease remission and are generally well tolerated, with minimal side effects. We propose a brief amendment to this document to clarify the language used and avoid inappropriate Medical Evaluation Board referrals.

Proton pump inhibitors display anti‐tumour potential in glioma

“…PPIs are kinds of stomach medicine with minimal side effects, generally. 34 Clinically, they are used to remedy peptic ulcers, gastroesophageal reflux disease, zoai syndrome and upper gastrointestinal bleeding having become the first‐line drugs for abnormal gastric acid secretion and related diseases. 35 , 36 , 37 , 38 However, different PPIs have different clinical application tactics and blood–brain barrier penetration (Table 1 ).…”