EoE Module 7 References-Aceves et al Gastrointest Endosc 2022 Endoscopic approach to EoE ASGE Consensus Conference

Aceves et al Gastrointest Endosc 2022 Endoscopic approach to EoE ASGE Consensus Conference

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The American Society for Gastrointestinal Endoscopy (ASGE) conducted a consensus conference to establish guidelines for the endoscopic management of eosinophilic esophagitis (EoE), a chronic allergic inflammatory disease of increasing prevalence. Endoscopy is essential in diagnosing, treating, and monitoring EoE, especially as non-invasive methods have yet to be developed. The panel of experts created twenty consensus statements using a modified Delphi process, focusing on biopsy techniques, disease activity assessment using the Endoscopic Reference System (EREFS), and endoscopic dilation for strictures.<br /><br />Key points from the conference include:<br />1. Biopsy methods: At least six biopsy samples should be taken from the esophagus for diagnosing EoE. Samples should be obtained from both the distal and mid-proximal esophagus regardless of endoscopic appearance.<br />2. Endoscopic Grading: The EREFS scoring system should be used routinely to assess disease activity, focusing on edema, rings, exudates, furrows, and strictures.<br />3. Response to Therapy: Endoscopy and biopsy, rather than symptoms alone, are essential to assess disease activity and the response to treatment changes.<br />4. Endoscopic Dilation: This procedure can be considered for EoE patients with strictures and dysphagia, and it is usually safe even in the presence of inflammation.<br /><br />The panel also highlighted that current literature lacks high-quality evidence, necessitating expert-derived guidance. Furthermore, they emphasized the need for ongoing research to improve diagnostic and treatment protocols. The consensus provides a framework for physicians and includes guidance for pediatric and adult gastroenterologists, thereby advancing understanding and management of EoE within clinical settings.

Keywords

ASGE

eosinophilic esophagitis

endoscopic management

biopsy techniques

EREFS scoring system

endoscopic dilation

consensus guidelines

disease activity assessment

pediatric gastroenterologists

adult gastroenterologists