Advanced Practice Provider EoE Program (Live/Virtual) | November 2024-2022 ASGE Consensus on EoE

2022 ASGE Consensus on EoE

Pdf Summary

The American Society for Gastrointestinal Endoscopy convened a consensus conference to discuss the endoscopic management of eosinophilic esophagitis (EoE), a chronic allergic disease that is increasingly prevalent. The gathering of 20 expert clinicians used a modified Delphi process to reach consensus on 20 statements to guide the use of endoscopy in the diagnosis and management of EoE. The document seeks to address the need for standardized tissue-sampling techniques, disease grading, and treatment strategies such as endoscopic dilation for those with esophageal strictures due to EoE. The statements include recommendations for taking at least six biopsy samples from different parts of the esophagus for accurate diagnosis, employing the Endoscopic Reference System (EREFS) for assessing disease activity, and recognizing the necessity of endoscopic dilation to relieve symptoms in patients with esophageal strictures or reduced esophageal caliber.<br /><br />Endoscopy is widely endorsed as the criterion standard for diagnosing EoE. Given the increased incidence of EoE, the authors stress the lack of noninvasive tests to evaluate the severity of the disease. Additionally, certain statements related to less invasive tests, standard protocols, and criteria for remission did not reach consensus, reflecting ongoing debates in the field. The panel agreed, however, that effective management of esophageal inflammation could reduce the necessity for dilation and that, despite some concerns, dilation remains a safe option for managing strictures in EoE patients.<br /><br />The consensus outcomes aim to standardize approaches and ultimately improve patient care. While they provide a framework for current best practices, the document anticipates further validation through future research. The conference's conclusions highlight endoscopy's critical role in managing EoE and the necessity for continuous review as new evidence emerges.

Keywords

Eosinophilic Esophagitis

Endoscopy

Consensus Conference

Modified Delphi Process

Tissue Sampling

Endoscopic Dilation

Esophageal Strictures

Endoscopic Reference System

Noninvasive Tests

Patient Care