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EoE Module 7 : The Role of Endoscopy in Therapy an ...
INSTRUCTION VIDEO: EoE Module 7
INSTRUCTION VIDEO: EoE Module 7
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Video Transcription
Hi, I'm Sachin Srinivasan, I'm one of the gastroenterologists at the University of Kansas Medical Center in Kansas City. Welcome to all of you. In this module, we're going to be talking about the endoscopic approaches to management of EOE, both in the short-term and long-term, and various approaches to manage and prevent complications. So in this module, the key things that we would cover are the endoscopic approaches not only to diagnosis, but also how to manage EOE in the short-term. When to perform an endoscopy, when to repeat an endoscopy. Notice the importance of endoscopy in the whole management of EOE. In addition, we'll also talk about the therapeutic approaches available to some of the complications that happen because of EOE, and how to prevent those complications while attempting endoscopic treatment. Endoscopy is still the gold standard in the management of EOE. While performing endoscopy, it is very important to have a detailed, structured report as to the findings on EOE. The ERF score has been long considered the standard in documentation of the findings of EOE. So it's very important that the learners pay attention to this particular score that's going to be in this module. The reason this is important is because studies have shown that the clinical symptoms not necessarily correlate with histology all the time. It's important to understand what the histology is, and how that plays into the prognosis of how a patient is doing with their therapies on EOE. The surveillance of EOE is also important. It's not a one-and-done condition, so it's important to follow these patients along regularly. Long-term, this becomes important to prevent strictures. Most of these strictures also need endoscopic intervention. Overall, the role of endoscopy in the diagnosis and management of EOE is very critical. The ERF score is a very important component of the documentation of endoscopic findings in EOE. It serves two important purposes. One, it gives a standard documentation of the findings of endoscopic findings, but also sets up a longitudinal follow-up where a patient's ERF score at baseline can be compared to what their ERF score was on future endoscopies. This would be important since one of the important areas in when we're evaluating management is resolution of these findings that are documented on the ERF score. This module on endoscopic management of EOE not only talks about specific areas in where the endoscopy plays a crucial role in immediate management, but also another key component, which is surveillance. It becomes a very important part of clinical care where we have started a patient on a particular treatment, be it proton pump inhibitors, swallowed corticosteroids. When do we bring this patient back for a repeat endoscopy? Should we bring this patient back for endoscopy? Once we have achieved remission, what's the next step? Is this something that we have to follow in the clinic? Is this something we can send back to the primary care provider? These are critical issues that come up in the management of EOE, and this module will address all of these. The management of EOE involves endoscopy with biopsies. After making a diagnosis of EOE and instituting the treatment, be it dietary therapy, be it PPI, or steroids, it is important to assess if there is improvement, not only clinically, but also endoscopically and histologically. So surveillance is a very important aspect in the management of EOE. The goal of EOE management is to achieve remission, clinical, endoscopic, and histology. That being said, once remission is achieved, the next key question that becomes is how do we follow this patient? How often do we follow this patient, whether we bring them back in clinic for annual visits, whether we perform regular endoscopies, or whether we just have them follow with the primary team to manage their symptoms. And that is an important discussion that needs to be had with the patient up front, but this is a condition which needs to be followed regularly in order to prevent long-term complications. Thank you everyone for watching this module. We hope you find this educational.
Video Summary
Dr. Sachin Srinivasan from the University of Kansas Medical Center discusses endoscopic approaches for managing Eosinophilic Esophagitis (EOE). The module emphasizes the importance of endoscopy in both diagnosing and treating EOE, highlighting the ERF score as crucial for documenting findings and tracking patient progress. Key topics include determining when to perform repeat endoscopies, managing EOE complications, and strategies for long-term surveillance to prevent esophageal strictures. The goal is achieving remission and deciding the frequency of follow-ups, whether through clinic visits, further endoscopies, or primary care management. Regular monitoring is essential to avoid complications.
Keywords
eosinophilic esophagitis
allergic conditions
multidisciplinary approach
risk factors
seasonality of allergies
endoscopic management
ERF score
esophageal strictures
long-term surveillance
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