Advanced Practice Provider EoE Program (Live/Virtual) | October 2025-Gastroesophageal Reflux Disease and EOE: Is it EOE? Recognizing the Signs

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Video Summary

The talk reviews esophageal symptoms, their causes, diagnostic tools, and focuses on gastroesophageal reflux disease (GERD) and eosinophilic esophagitis (EOE). Common esophageal symptoms include heartburn, regurgitation, dysphagia, odynophagia, globus sensation, and water brash. Causes are structural (e.g., rings, strictures), motility disorders, or sensory issues, often overlapping. Diagnostic tools include barium esophagram, endoscopy with Bravo monitoring, esophageal manometry, and EndoFLIP.<br /><br />GERD’s typical symptoms are heartburn and regurgitation, but it can cause dysphagia and overlaps with EOE. GERD is multifactorial, involving acid reflux, motility issues, and anatomical defects like hiatal hernia. Extraesophageal symptoms include chest pain, asthma, cough, hoarseness, and throat clearing. Complications include peptic strictures, Barrett’s esophagus, and esophageal adenocarcinoma. Treatment emphasizes lifestyle changes, proton pump inhibitors (PPIs) as first-line therapy, and surgery (fundoplication) for refractory cases, noting potential side effects.<br /><br />EOE is an immune-mediated chronic disorder seen mainly in young adults causing dysphagia and food impaction. Diagnosis requires multiple biopsies from different esophageal sites and can be aided by esophagram showing characteristic structural changes. Treatments include PPIs, topical steroids, elimination diets, and biologics for refractory cases.<br /><br />Differentiating GERD from EOE involves clinical symptoms, endoscopy, esophagram, pH testing, and histology. Other discussed conditions include Zenker’s diverticulum and motility disorders like achalasia and scleroderma. Achalasia features impaired esophageal peristalsis and LES relaxation; scleroderma causes hypotensive LES and severe reflux. Comprehensive evaluation and tailored management, including shared decision-making with patients, are essential.

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Sarel J. Myburgh, APRN, CNP, MS

Keywords

esophageal symptoms

gastroesophageal reflux disease

eosinophilic esophagitis

diagnostic tools

heartburn

proton pump inhibitors

achalasia

esophageal manometry