ASGE Esophagology General GI Practice Virtual Program (LIVE Virtual) | April 2021-Thinking About EoE During Your EGD

Video Transcription

Video Summary

In this video, Shivangi Kothari, an Associate Professor at the University of Rochester, discusses eosinophilic esophagitis (EOE) during endoscopy diagnosis and dilation. She thanks the course directors and the ASG for giving her the opportunity to give this talk. Kothari reviews the diagnostic criteria for EOE, which includes symptoms of esophageal dysfunction, greater than 15 eosinophils per high-power field on esophageal biopsy, isolation of eosinophilic infiltration to the esophagus, and ruling out other esophagitis disorders. She emphasizes the importance of a high clinical suspicion and a detailed history before conducting an endoscopy. Kothari explains that EOE is strongly associated with atopic diseases such as asthma, allergic rhinitis, sinusitis, atopic dermatitis, and food allergies. She highlights the endoscopic findings of EOE, including fixed esophageal rings, furrows, whitish plaques, esophageal narrowing, strictures, mucosal edema, and decreased vascularity. Kothari outlines the diagnostic criteria for EOE, which include increased eosinophils in the esophageal epithelium and the presence of eosinophilic microabscesses. She also discusses alternative etiologies that need to be excluded, such as GERD. Kothari mentions adjunctive modalities for diagnosis, such as barium swallow, pH testing, and esophageal manometry. She concludes her talk by discussing the treatment of EOE, specifically the role of endoscopic dilation in the initial and maintenance therapy of EOE strictures. Kothari explains that dilation should be performed in conjunction with medical treatment and diet therapy to decrease the rate of stricture recurrence. She provides practical tips for performing endoscopic dilation and emphasizes the importance of informed consent and thorough post-procedure care. Overall, Kothari provides a comprehensive overview of EOE diagnosis, endoscopic findings, and treatment options.

Asset Subtitle

Shivangi Kothari

Keywords

eosinophilic esophagitis

endoscopy diagnosis

dilation

diagnostic criteria

esophageal dysfunction