ASGE Annual Postgraduate Course Endoscopy 2022: Breakthrough to Excellence

Katzka_EoE Consensus Conference

Pdf Summary

The ASGE Consensus Conference on the endoscopic approach to eosinophilic esophagitis (EoE) discussed various aspects of diagnosis, response to therapy, endoscopic dilation, and monitoring disease. <br /><br />For the diagnosis of EoE, it was recommended that at least 6 biopsies be taken from the esophagus, including the distal and mid/proximal esophagus. Biopsies should be obtained regardless of endoscopic appearance. Additionally, biopsies from the stomach and duodenum should be taken to assess for eosinophilic gastroenteritis in patients with compatible symptoms. <br /><br />The EOE Endoscopic REFerence System (EREFS) should be used to assess EoE activity during endoscopy, with an improvement in inflammatory features as a desired endpoint of therapy. <br /><br />When assessing response to therapy, endoscopy and biopsy should be performed. Symptoms alone are not sufficient. <br /><br />Endoscopic dilation can be considered for patients with EoE and esophageal strictures with dysphagia. The goal is to achieve a luminal diameter that relieves dysphagia, typically at least 16mm. Different dilation techniques can be used, and dilation can be done in conjunction with medical or dietary therapy for management of dysphagia. <br /><br />Monitoring disease in patients with EoE in remission should include continued symptom monitoring, periodic endoscopy, and biopsy. <br /><br />Overall, there were areas of controversy and the need for further research to understand the natural history of EoE. The consensus conference provided expert opinions on various aspects of the endoscopic approach to EoE, but the recommendations were not graded.

Keywords

ASGE Consensus Conference

endoscopic approach

eosinophilic esophagitis

diagnosis

response to therapy

endoscopic dilation

monitoring disease

biopsies

EoE Endoscopic REFerence System

inflammatory features