EoE Module 7 References-Dellon Clin Gastroenterol Hepatol 2021 Optimizing the endoscopic examination in EoE

Dellon Clin Gastroenterol Hepatol 2021 Optimizing the endoscopic examination in EoE

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The article, "Optimizing the Endoscopic Examination in Eosinophilic Esophagitis," by Evan S. Dellon, explores methods to enhance the accuracy and efficacy of endoscopic examinations for diagnosing and treating eosinophilic esophagitis (EoE). As the incidence of EoE rises, healthcare providers will encounter it more frequently, especially in cases involving dysphagia and food impaction.<br /><br />Dellon emphasizes the importance of a meticulous esophageal examination during endoscopy, highlighting the need to identify specific EoE features using the EoE Endoscopic Reference Score (EREFS), which grades edema, rings, exudates, furrows, and strictures. Correct assessment using EREFS requires full insufflation of the esophagus to clearly distinguish between transient and fixed esophageal features. Accurate recording of these observations is crucial for diagnosis, monitoring disease activity, and evaluating responses to treatment.<br /><br />The article also addresses challenges in detecting strictures and esophageal narrowing, which can be subtle and easily missed during visual inspection. Dellon advocates for a careful examination approach and suggests the use of smaller scopes when encountering resistance to avoid complications. Furthermore, proper biopsy techniques are critical for effective histological assessments, as EoE frequently shows patchy eosinophilic infiltration. Clinical guidelines recommend obtaining multiple biopsies from different esophageal locations, targeting active disease features.<br /><br />Take-home points underline the significance of thorough examinations, complete with EREFS scoring and appropriate biopsies, to improve diagnostic yields and subsequent management strategies for EoE. The alignment of endoscopic practices with these strategies ensures a comprehensive understanding of the disease's endoscopic and histological landscape, ultimately informing better treatment and monitoring methods.

Keywords

Eosinophilic Esophagitis

Endoscopic Examination

EREFS

Dysphagia

Food Impaction

Esophageal Strictures

Biopsy Techniques

Histological Assessment

Diagnostic Yield

Treatment Strategies