Advanced Practice Provider EoE Program (Live/Virtual) | October 2025-Q and A

Video Transcription

Video Summary

In this expert panel discussion on Eosinophilic Esophagitis (EOE), key topics included the current reliance on histology for diagnosis despite interest in biomarkers, and optimal biopsy protocols—taking six or more biopsies from inflamed proximal and distal sites. The panel emphasized the value of endoscopic reference scores (eREFs) for longitudinal tracking. Treatment choices among PPIs, steroids, and elimination diets depend on patient motivation, disease severity, and shared decision-making, with biologics like dupilumab used earlier in select cases. Secondary causes of esophageal eosinophilia are rarely chased unless clinically suspected. Regarding esophageal dilation techniques, balloon dilators allow controlled visualized dilation, while Savary dilators can be better for fibrotic strictures due to different mucosal effects; multimodal approaches may be beneficial. Post-dilation care includes soft diets and symptom monitoring, with clear triage protocols for post-procedure chest discomfort to differentiate normal healing from complications. Overall, personalized management and interdisciplinary collaboration were emphasized.

Keywords

Eosinophilic Esophagitis

Histology diagnosis

Biopsy protocols

Endoscopic reference scores

Esophageal dilation techniques