I'm Seema Asavis. I am a pediatric allergist at the University of California, San Diego and at Rady Children's Hospital and also in San Diego. And hi, I'm Jennifer Lightdale. I'm a pediatric gastroenterologist at Boston Children's Hospital and associate chief there of the division. So hi, welcome to the module on optimal multidisciplinary team approach or module 13 of this series. And it is my great pleasure as a gastroenterologist to really discuss this area of multidisciplinary team work around eosinophilic esophagitis. As a gastroenterologist, it's really important to recognize all the other players that must be involved really to provide optimal care for anybody who gets diagnosed with EOE. I'm in pediatric GI, so certainly kids definitely need multidisciplinary care, but adults do as well. And it's really important in particular to work with our allergists. So I'm thrilled that Dr. Asavis is part of us getting this module going. But we also work with dieticians, psychologists, and other people who can be very important in providing integrated care. Thanks, Dr. Lightdale. It's a pleasure to be a part of this module. And hopefully with this, you'll get some practical help on how to take care of your patients with EOE, especially how aeroallergens and other allergic diseases like food allergies could influence their disease, their progression, perhaps their response to therapy, and really how to best work as a team to create a care management plan that is optimal for your patient, of course, involving pediatric GI, dietary psychologists, pathologists, and allergists. So with this module, we hope that it will help you to build a multidisciplinary EOE team and think about those practitioners that you can work with that will really help to optimize the care of your EOE patients. Of course, as a gastroenterologist, you're going to be making that diagnosis, doing the endoscopy. And then how do you really help the whole allergic person? Because this is a type two inflammatory disease. So how do you think about caring for their food allergies or their aeroallergens or caring for their eczema or concurrent atopic diatheses? And that can really help you to modulate the plan that you might be building. And how are you going to integrate that in terms of actually seeing the patient and reviewing the chart and building a care team plan? Yeah, and as a gastroenterologist, I can tell you that sometimes interpreting the food allergy history from the patient, but also the tests that you may get back is really complex, and it can be helpful to work with your allergy colleagues to sort that out. I have had many patients who think they're allergic to things. It's helpful to work with an allergist to confirm that. And of course, again, designing the right diet, I think, can make a big difference. And then yes, I think I tend to feel a bit helpless around aeroallergen eczema. So it's really helpful when you guys have much more practical ways of trying to tackle that piece of the disease. So this module is really going to give you a lot of practical advice on pulling together your best team. Sometimes that team is going to be housed under one roof and under one clinic visit. And sometimes you just have a team that's, you know, that you're going to be now tagging the patient and telling them to go to various people who you know are going to be very helpful at getting the best care for that patient. And again, that would include probably an allergist, a dietician at minimum, and perhaps a psychologist or other counselor to help with the discussions around chronic disease and how that can affect people. I do think the module, from my perspective, is best used going through the slides first and making your way towards the case and the resources. But it's all about personal preference and how you want to introduce the topic. And I agree with everything that you've said, Jennifer. And I think some of the practicalities of this module also incorporate, as you said, how to build this best care team and the practicalities of are you going to be in the same place? Will you be communicating? And then also how to interpret the data so that we are presenting a care plan to the patient that is really integrated in a way that makes sense to them. So if I can help you decide, for example, when to do an endoscopy because somebody has a lot of aeroallergen allergies and that pollen exposure may influence the eosinophilia in their esophagus or somebody who thinks they're allergic to a food because they've got a positive test, but perhaps that doesn't really indicate that they're allergic at all. And so working as a team will hopefully help us to understand our goals and then present a integrated plan for our patients. I would say that one of the main takeaways from this module that you can use is the concept that really to provide high quality care for your patient, it's best to integrate the care with multiple disciplines, including, of course, GI, a nutritionist, a psychologist, an allergist, and that this really will help to have your patient understand the plan and also to adhere to the plan. And from an allergy standpoint should help them understand perhaps when they should have an endoscopy done in terms of seasonality or symptoms related to seasonality and really what allergy testing means and importantly, what it does not mean for your patient. Yeah. And I would say as the gastroenterologist that this is one of those conditions where you want to know your colleagues out there in your area, in your town, in your city, in your state, who you feel you work well with and who are going to be able to speak the same language as you when they're counseling patients around EOE. And the bottom line to this whole module is really it's teamwork that makes the dream work, as they say, and that's really the best way to give great care for EOE. We certainly wish you the best of luck in using this module and hope that it helps with your care. Yes. And, you know, I'm sure you all are learning so much about EOE and I'm hopeful this module really puts you even further down that pathway.

eosinophilic esophagitis

treatment options

proton pump inhibitors

topical steroids

dupilumab

multidisciplinary approach

integrated care team

pediatric allergist

food allergies