EoE ToT Module 3 References-Aceves et al Gastrointest Endosc 2022 Endoscopic approach to eosinophilic esophagitis ASGE consensus conference PIIS0016510722017254

Aceves et al Gastrointest Endosc 2022 Endoscopic approach to eosinophilic esophagitis ASGE consensus conference PIIS0016510722017254

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The "American Society for Gastrointestinal Endoscopy Consensus Conference" on eosinophilic esophagitis (EoE) focused on the endoscopic management of the disease, offering 20 consensus statements developed through a modified Delphi process involving 20 experts. Endoscopy is crucial in diagnosing and managing EoE, including assessing treatment response, treating esophageal strictures, and continuous monitoring even in histological remission.<br /><br />Key recommendations include taking at least six biopsy samples from different sections of the esophagus during diagnosis due to the patchy nature of EoE. Biopsy samples should be obtained regardless of visible endoscopic abnormalities, especially during initial food impaction presentations. The Endoscopic Reference System (EREFS) should be used routinely for assessing disease activity due to its validated capacity to characterize major EoE features and predict treatment outcomes.<br /><br />Endoscopic dilation is recommended for patients with EoE presenting with strictures and dysphagia, with the goal being to achieve a luminal diameter of at least 16 mm over one or more sessions. While dilation procedures are generally safe, careful and gradual dilation is advised to minimize perforation risks, ideally combined with anti-inflammatory therapy to reduce the frequency and need for future dilations.<br /><br />Continuous monitoring through symptoms, periodic endoscopy, and biopsy sampling is essential, even in patients showing remission, due to EoE's chronic and progressive nature. Controversies remain on certain practices, like the necessity of multiple jars for biopsy samples or specific cutoff scores for EREFS in defining remission or relapse.<br /><br />Overall, the consensus statements aim to provide comprehensive advice on the use of endoscopy in EoE patient care, while acknowledging the necessity for further research to solidify and potentially expand these guidelines.

Keywords

Eosinophilic Esophagitis

Endoscopy

Consensus Conference

Biopsy Samples

EREFS

Esophageal Strictures

Endoscopic Dilation

Chronic Disease

Anti-inflammatory Therapy

Treatment Monitoring