ASGE Annual Postgraduate Course Endoscopy 2022 (On-Demand): Breakthrough to Excellence-Katzka

Katzka_EoE Consensus Conference

Pdf Summary

The ASGE Consensus Conference on the endoscopic approach to eosinophilic esophagitis (EoE) discussed various aspects of diagnosis, monitoring, and treatment. <br /><br />For the diagnosis of EoE, it is recommended to take at least 6 biopsies from the esophagus, including the distal and mid/proximal areas, regardless of the endoscopic appearance. Biopsies from the stomach and duodenum should also be considered to assess for eosinophilic gastroenteritis. The EOE Endoscopic REFerence System (EREFS) should be used to assess EoE activity during endoscopy, and an improvement in inflammatory features is a desired endpoint of therapy.<br /><br />Endoscopy and biopsy are necessary to assess EoE activity before and after any changes in therapy. In patients with EoE and esophageal strictures, endoscopic dilation can be considered, with a goal luminal diameter that relieves dysphagia and food impaction. Different dilation techniques can be used, and dilation therapy should be done in conjunction with medical or dietary therapy for management of dysphagia.<br /><br />Monitoring with symptoms and periodic endoscopy and biopsy should be considered in patients with EoE in remission. <br /><br />The consensus conference used a Delphi approach and expert opinion to address major questions and areas of controversy in the field. Understanding the natural history of EoE is deemed important for further advancement in diagnosis and management.<br /><br />It is worth noting that the author of the document has declared a financial relationship with Takeda and Celgene in the form of consulting.

Keywords

eosinophilic esophagitis

diagnosis

monitoring

treatment

biopsies

endoscopy

dysphagia

remission

Delphi approach

consulting