Okay, everybody, I think we're coming to Part 2 and almost towards the end of Day 2 here. Bernie, if you could pull up our knowledge, there you go. So the same as yesterday, but different set of questions. And so get out your phones or your devices to scan the code. Same process. You get the ready to play, you hit continue, you put in your first, last name and your email address, click submit. You get the little countdown and you start answering the questions. I'll give you, since it kind of seemed like do this in about 10 minutes yesterday, I'll set my timer for about 10 minutes and give you time to go through the questions. And then we will go through the questions and correct responses afterwards. So go ahead and get started. And I'll set the timer right now for 10 minutes. All right. So which food group is associated with the highest risk of esophageal eosinophilia? Strong work. Nice. What's the second most common? Yep. Nice. All right. What? Okay. Like, we all know this. Excellent. Yes. You know it. All right. Perfect. So 15. However, do you think that eosinophils are going to be the only pathology marker we're going to be looking at forever? Yeah, exactly. All right. An esophageal biopsy with very high levels of eosinophils is always EOE or acid reflux? Yeah. Any question with always in true and false, we're taught is not true, right? So that kind of gave it away. What are other things that can cause eosinophils in the esophagus? Possibly. Yeah. It's associated with celiac disease. Yeah. Crohn's is another thing that we think about. Treatments are patients that get radiofrequency ablation, where they cauterize for Barrett's esophagus with dysplasia. They can get eosinophils too. Yeah. So all of the following are associated with a higher risk of EOE except... Yep. Yeah. More temperate. Yep. So we know male sex, three times more common, atopics, and we talked about antibiotics and infancy and early life. So what percent of food impactions? Yeah. So it's a lot. So roughly 50%. So I've talked to several people about this on the breaks of how we're trying to educate our fellows as well as other groups to make sure that they're getting the biopsies, even though it's the middle of the night and you're taking out the food, getting those biopsies and getting the diagnosis right away is important or patients will be lost to follow-up. So all of the following are associated with esophageal eosinophilia except what? So we already heard celiac disease is associated. So we know that one's right. Yep. So inflammatory bowel disease is associated. So maybe there's a connection with the microbiome. We already know acid reflux, high rate, and then pill-induced esophagitis. As Dr. Solera had showed, you can also have the eosinophils. So associated with all of these signs and symptoms except what? Yeah, exactly. Okay. Strong work. Okay. Yeah. I showed you that in that one diagram. That was the first thing. When the seroallergens and the food antigens get in there, that's the first thing when you get the epithelial damage that's released, the TSLP, and that's what's going to stimulate that whole Th2 pathway. What's not part of the Ds for treatment? Yeah, exactly. Nice. Okay. And then what was the extra D that was in the slides? Exactly. So now we have the dupilumab D. Perfect. And which of the following is an acceptable first-line therapy for EOE? B? Okay. Yeah. H2 blockers are not going to work through the Th2 pathway, anti-TNFs, we know that we use those for inflammatory bowel disease, and then the 5-aminosalicylates. All right. Excellent. And what's the response rate for... Sorry. That one went a little fast. I don't know why I did that. Going back to the other one, you said proton pump inhibitors, what's the response rate of proton pump inhibitors? Exactly. 40-50%. Perfect. I'm not sure why this one came up with it already on there, but this one I think they updated it, right? Did you guys all put the budesonide oral suspension on there? Okay. Good. Because like we talked about, that was just FDA approved in February, so newer indication. Okay. What is the most common adverse event after dilation? Yeah, exactly. The chest pain. As I talked about multiple times, we have to let our patients have a heads up on that just because we need them to recognize it may happen and not be scared if they do feel some of it. But if it's severe, they need to let us know. Perforation like we talked about is very rare. What's true? Control of inflammation reduces the need for endoscopic dilation, maintenance topic steroids should be avoided, H2 blockers improve esophageal eosinophilia, or allergy-tested guiding dietary restriction is more effective than an empiric six-food elimination diet. Yeah. Exactly. So again, when we're talking about narrowing in the esophagus, there's this mixture of the inflammatory and the fibrostenotic component. Which of the foods should be avoided in a two-food elimination diet? Yeah. So the two most common. Okay, excellent. Which of the following is true in EOE? Once eosinophilia is controlled, relapse is rare after the medications are discontinued. Fibrostenotic strictures are more common when diagnosis is delayed. Children's are more likely than adults to have strictures. And symptom resolution is a reliable indicator of improved eosinophilic inflammation. Yeah. We talked about that multiple times. Off therapy, delaying diagnosis, that chart we showed you every decade, doubling effect for strictures. All right. That was it. So, you know, there was three people that played my game. And for all of you, I'm going to recognize all three of them, and I'm going to bring up what they did. And then they can tell you what the rest of you missed out on. So, go to the next slide, Barney, for me, please. So Earl Tucker, I want all three of you to come up at the same time. Earl Tucker talked about GIs are not perfect at assessing esophageal diameter, poor correlation between allergy testing and diet therapy. Kim talked about the capsule endoscopy, asking community GIs if they actually use this, and it is just how thin the esophagus is, the two-millimeter comment that was made yesterday. And then the IBD, similar goals to EOE, is often compared to EOE, and I think we talked about that today a little bit, didn't we, in the panel discussion? And then Kelsey on the liver, you know, the 500-plus vital functions and, you know, what it produces and the breakdown of drug toxins and alcohol. So all three of you, Kelsey, Kim, and Earl, come up here. Did Earl leave on me? No. I told him I'd mail it. All right. Well, congratulations, and thank you. And you can tell everybody what, you know, you've received out of that, okay? All right. So for our knowledge questions, and Dina, help me out here a little bit when I call everybody up. So our average score was 8,000 out of 5,000. So that's a pretty good score. So our knowledge questions, and Dina, help me out here a little bit when I call everybody up. So our average score was 8,006 points, okay? And remember, this is all based on timing and your correct response. So number five is Lance Leader at 11,013. Good job, Lance. Number four is Josh Tanney at 11,088. Great job, Josh. Thank you for playing. Number three, Melanie DeFusco at 11,539. There we go. Thank you. Thank you. And number two was Lela Jackson at 12,188. Congratulations. And our winner today, our number one winner was Kim Lane at 12,727 points. Yep. The big one. Good job, everybody. Man, you're winning every time. Yeah, strong work. All right. Good job. You're welcome. I just, final words from you, Diana, and Mimi, I think might still be on, but I just want, from my standpoint, I just want to thank you all. I hope it's been a couple of days of great information, great interaction. I know we had to do a little bit of going to some plan Bs here, but I think it worked out very beautifully. And I want to thank the faculty also for everything. I think we got just a few minutes. I don't know if there's any, like, final question, or Diana or Mimi, if you've got any final comments or key points you want to take, you know, have people part home with. Yeah, I just wanted to say something, Ed. I just wanted to thank everyone for partnering with us on this. I mean, it's always, this is probably our fourth time that we've done this, and I'm always really amazed at the engagement of the audience and your thoughtful questions and your desire to really want to know about EOE. I would say going back, you know, 20-something years, we in the EOE space were just desperate to get, you know, companies to partner with us and understand this disease and to see it come to this fashion and have you all in this room trying to understand the disease, trying to talk to our patients and understand their journey. It has been just miraculous and wonderful. So, from the EOE physician community, we really, really appreciate you and partnering with us. And I want to say a special thank you to ASGE for making this virtual thing happen. Special thank you to Drs. Yoon and Snyder for kind of stepping in and moderating and really all our faculty who made this very successful. And I'd love to hear from you guys if you have any other parting thoughts. Say thank you for including me. And this is my first time presenting at this conference, so it was really nice to see how motivated you all are. And I really appreciate it, Dr. Gonsalves and ASGE, for including us. So, thank you so much. Thank you.

esophageal eosinophilia

diagnostic markers

treatment options

quiz winners

event engagement