ASGE Recognized Industry Associate (ARIA) Training Program for Regeneron and Sanofi | June 2023-Epidemiology and Diagnosis of EoE

Video Transcription

Video Summary

In this video, Dr. Gonzalez discusses the epidemiology, definition, clinical presentation, pathophysiology, and natural history of eosinophilic esophagitis (EOE). EOE is a chronic immune-mediated food antigen-driven disease characterized by symptoms related to esophageal dysfunction and eosinophil predominant inflammation in biopsy specimens. The cutoff for eosinophils is more than 15 eosinophils per high-powered field. The disease is isolated to the esophagus and is not considered EOE if eosinophils are present in the stomach or small intestine. The prior definition required patients to have failed a proton pump inhibitor (PPI) trial, but this changed in 2018 and PPI treatment is now considered a treatment rather than a diagnostic tool. EOE has been known since the 1970s but was frequently misdiagnosed as reflux until the late 1990s when the disease became better understood. EOE is more common in young males and is associated with other atopic conditions. Diagnostic delay and fibrostenosis can occur over time, so early diagnosis and treatment are important to prevent progression. The video also discusses the importance of taking multiple biopsies to increase the diagnostic yield of EOE and the importance of taking biopsies at the time of food impaction to diagnose EOE. Overall, the video provides a comprehensive overview of EOE, including its clinical features and the evolution of its diagnosis and treatment.

Asset Subtitle

Nirmala Gonsalves, MD

Keywords

eosinophilic esophagitis

epidemiology

definition

clinical presentation

pathophysiology

natural history

chronic immune-mediated

food antigen-driven disease