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Eosinophilic esophagitis (EOE)

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https://www.readbyqxmd.com/read/28508868/influence-of-age-and-eosinophilic-esophagitis-on-esophageal-distensibility-in-a-pediatric-cohort
#1
Calies Menard-Katcher, Alain J Benitez, Zhaoxing Pan, Faria N Ahmed, Benjamin J Wilkins, Kelley E Capocelli, Chris A Liacouras, Ritu Verma, Jonathan M Spergel, Glenn T Furuta, Amanda B Muir
OBJECTIVES: Sequelae of eosinophilic esophagitis (EoE) include food impaction and esophageal stricture. Duration of inflammation is a predicted risk factor; however, complications remain unpredictable. Studies using the functional lumen imaging probe (FLIP) have demonstrated decreased distensibility of the esophagus in adult patients with EoE. As the impact of inflammation on the developing esophagus is unknown, we investigated esophageal distensibility in a pediatric cohort to determine the effect of age, ongoing inflammation, and fibrotic features on distensibility...
May 16, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28507746/guidelines-on-eosinophilic-esophagitis-evidence-based-statements-and-recommendations-for-diagnosis-and-management-in-children-and-adults
#2
REVIEW
Alfredo J Lucendo, Javier Molina-Infante, Ángel Arias, Ulrike von Arnim, Albert J Bredenoord, Christian Bussmann, Jorge Amil Dias, Mogens Bove, Jesús González-Cervera, Helen Larsson, Stephan Miehlke, Alexandra Papadopoulou, Joaquín Rodríguez-Sánchez, Alberto Ravelli, Jukka Ronkainen, Cecilio Santander, Alain M Schoepfer, Martin A Storr, Ingrid Terreehorst, Alex Straumann, Stephen E Attwood
INTRODUCTION: Eosinophilic esophagitis (EoE) is one of the most prevalent esophageal diseases and the leading cause of dysphagia and food impaction in children and young adults. This underlines the importance of optimizing diagnosys and treatment of the condition, especially after the increasing amount of knowledge on EoE recently published. Therefore, the UEG, EAACI ESPGHAN, and EUREOS deemed it necessary to update the current guidelines regarding conceptual and epidemiological aspects, diagnosis, and treatment of EoE...
April 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28505050/unsedated-in-office-transgastrostomy-esophagoscopy-tge-to-monitor-therapy-in-pediatric-esophageal-disease
#3
Caroline H T Hall, Nathalie Nguyen, Glenn T Furuta, Jeremy Prager, Emily Deboer, Robin Deterding, Calies Menard-Katcher, Kelley E Capocelli, Robert E Kramer, Joel A Friedlander
Monitoring therapy in esophageal inflammatory disorders such as eosinophilic esophagitis (EoE) and reflux esophagitis often requires frequent endoscopic evaluation. We recently reported the effective use of unsedated in office Transnasal Esophagoscopy (TNE) that significantly decreased costs and anaesthetic exposure associated with pediatric esophagoscopy in EoE. Here we report a series of pediatric patients with esophagitis with gastrostomy tubes who underwent unsedated transgastrostomy esophagoscopy (TGE) in an office setting...
May 12, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28502433/eosinophilic-gastrointestinal-disorders
#4
REVIEW
Lisa M Fahey, Chris A Liacouras
Eosinophilic esophagitis (EoE) is an atopic disease that is characterized by an isolated infiltration of eosinophils into the epithelium of the esophagus and is triggered by specific allergens. Patients should undergo an upper endoscopy with biopsy after 6 to 8 weeks of treatment with a proton pump inhibitor in order to make the diagnosis of EoE. Eosinophilic gastroenteritis is a pathologic eosinophilic infiltration of any portion of the gastrointestinal tract, and eosinophilic proctocolitis is an eosinophilic infiltration in the colon alone...
June 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28501533/promising-modalities-to-identify-and-monitor-eosinophilic-esophagitis
#5
Girish Hiremath, Sandeep K Gupta
Eosinophilic esophagitis (EoE) is an allergen-mediated condition characterized by symptoms of esophageal dysfunction and histological evidence of intense eosinophilic inflammation involving the esophagus in absence of overlapping conditions such as gastroesophageal reflux disease. Since the initial description as a distinct entity about two decades ago, there has been a remarkable rise in the recognition of this clinico-pathologic entity. Current approach to diagnose and monitor EoE requires repeated esophagogastroduodenoscopies (EGDs), with associated sedation/anesthesia, to visualize mucosal abnormalities, and to obtain multiple biopsies for histologic assessment and to evaluate treatment response...
May 10, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28489670/retrospective-comparison-of-fluticasone-propionate-and-oral-viscous-budesonide-in-children-with-eosinophilic-esophagitis
#6
Jacqueline M Fable, Marina Fernandez, Susan Goodine, Trudy Lerer, Wael N Sayej
BACKGROUND: Eosinophilic esophagitis (EoE) is treated with dietary modification and/or pharmacologic management with swallowed topical steroids (TS). Swallowed fluticasone propionate (FP) and oral viscous budesonide (OVB) have proven to be effective in resolving symptoms and reversing histologic changes in children and adults with EoE. There are minimal comparative studies between the two agents. AIM: To retrospectively compare endoscopic and histologic outcomes following FP versus OVB therapy in children with EoE in our center...
May 9, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28461094/esophageal-dilation-with-either-bougie-or-balloon-technique-as-a-treatment-for-eosinophilic-esophagitis-a-systematic-review-and-meta-analysis
#7
REVIEW
Michael Dougherty, Thomas M Runge, Swathi Eluri, Evan S Dellon
BACKGROUND AND AIMS: Esophageal dilation is a now recognized to be an important therapeutic modality in eosinophilic esophagitis (EoE). We aimed to evaluate the safety of esophageal dilation in EoE, especially regarding perforation risk, and to examine perforation risk by dilator type. METHODS: We conducted a systematic review of the published literature from January 1, 1950 to June 30, 2016 using Pubmed, EMBASE, and Web of Science. Studies were included if they described patients with EoE who underwent esophageal dilation and also reported the presence or absence of at least 1 adverse event (eg, perforation, bleeding, pain, or hospitalization)...
April 28, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28445189/proton-pump-inhibitor-responsive-esophageal-eosinophilia-still-a-valid-diagnosis
#8
Javier Molina-Infante, Pedro L Gonzalez-Cordero, Alfredo J Lucendo
PURPOSE OF REVIEW: To update rapidly evolving concepts regarding the controversial entity of 'proton pump inhibitor (PPI)-responsive esophageal eosinophilia,' referring to patients with clinical, endoscopic and histologic features of eosinophilic esophagitis (EoE) who achieve remission on PPI therapy. RECENT FINDINGS: Up to half of pediatric and adult patients with typical EoE symptoms and histology achieve clinico-pathologic remission on PPI therapy, irrespective of whether esophageal pH monitoring demonstrates abnormal acid reflux...
April 25, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28441986/medical-therapy-versus-dietary-avoidance-in-eosinophilic-esophagitis-which-approach-is-better
#9
Mirna Chehade, Ellen Sher
BACKGROUND: Eosinophilic esophagitis (EoE) is a chronic immune-mediated esophageal disease characterized by esophageal symptoms and esophageal eosinophilia. It is induced by food triggers and by environmental allergens in some patients. No U.S. Food and Drug Administration approved therapies exist for patients with EoE. Common therapies include topical corticosteroids (TCS) and dietary restriction. METHODS: This article reviewed the pros and cons of a medical versus dietary approach in treating EoE in children and adults...
May 1, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/28429201/how-to-approach-lymphocytic-esophagitis
#10
REVIEW
Anh D Nguyen, Kerry B Dunbar
PURPOSE OF REVIEW: Lymphocytic esophagitis (LE) is an unusual esophageal condition defined by an increased number of lymphocytes in the esophageal epithelium. With few published studies of LE available, it is unclear whether LE is a truly distinct clinical entity or a histological manifestation of other known gastrointestinal disorders. This review summarizes recent studies of lymphocytic esophagitis. RECENT FINDINGS: Studies have suggested that LE may be related to eosinophilic esophagitis (EoE) or a manifestation of gastroesophageal reflux disease (GERD)...
June 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28428721/proposed-criteria-to-differentiate-heterogeneous-eosinophilic-gastrointestinal-disorders-of-the-esophagus-including-eosinophilic-esophageal-myositis
#11
Hiroki Sato, Nao Nakajima, Kazuya Takahashi, Go Hasegawa, Ken-Ichi Mizuno, Satoru Hashimoto, Satoshi Ikarashi, Kazunao Hayashi, Yutaka Honda, Junji Yokoyama, Yuichi Sato, Shuji Terai
AIM: To define clinical criteria to differentiate eosinophilic gastrointestinal disorder (EoGD) in the esophagus. METHODS: Our criteria were defined based on the analyses of the clinical presentation of eosinophilic esophagitis (EoE), subepithelial eosinophilic esophagitis (sEoE) and eosinophilic esophageal myositis (EoEM), identified by endoscopy, manometry and serum immunoglobulin E levels (s-IgE), in combination with histological and polymerase chain reaction analyses on esophageal tissue samples...
April 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28425585/eosinophilic-esophagitis-unclear-roles-of-ige-and-eosinophils
#12
REVIEW
C Blanchard, D Simon, A Schoepfer, A Straumann, H-U Simon
Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the oesophagus. Recognized as a distinct entity only two decades ago, the emergence of the disease along with the availability of new technologies has rapidly opened new research avenues and outlined the main features of the pathogenesis of EoE. Yet, each advance in our understanding of the disease has raised new questions about the previous consensus. Currently, new subsets of the disease challenge our diagnostic criteria. For instance, it was believed that EoE did not respond to proton pump inhibitor (PPI) therapy; however, it has now been shown that a substantial proportion of EoE patients indeed respond to PPIs...
May 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28417991/esophageal-and-small-intestinal-mucosal-integrity-in-eosinophilic-esophagitis-and-response-to-an-elemental-diet
#13
Marijn J Warners, Berber J Vlieg-Boerstra, Joanne Verheij, Patricia H P van Hamersveld, Bram D van Rhijn, Marleen T J Van Ampting, Lucien F Harthoorn, Wouter J de Jonge, Andreas J P M Smout, Albert J Bredenoord
OBJECTIVES: The esophageal mucosal integrity is impaired in eosinophilic esophagitis (EoE) and it has been suggested that the duodenal permeability is increased. The absence of food allergens may restore the integrity. The aims of this study were to assess duodenal permeability in EoE and to evaluate the effect of an elemental diet on the esophageal and duodenal integrity. METHODS: In this prospective study 17 adult EoE patients and 8 healthy controls (HC) were included...
April 18, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28383396/role-of-endoscopic-esophageal-dilation-in-managing-eosinophilic-esophagitis-a-systematic-review-and-meta-analysis
#14
REVIEW
Harsha Moole, Kavitha Jacob, Abhiram Duvvuri, Vishnu Moole, Sowmya Dharmapuri, Raghuveer Boddireddy, Achuta Uppu, Srinivas R Puli
BACKGROUND: Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disorder of the esophagus characterized by mucosal eosinophilic infiltration. Topical glucocorticoids are considered standard line of treatment, whereas endoscopic dilations are performed for patients presenting with treatment-resistant disease or manifestations of dysphagia and/or food impactions. Efficacy and safety of esophageal dilation in these patients are currently unclear. AIMS: Primary outcomes were to evaluate the efficacy, adverse events, and mortality rates of endoscopic esophageal dilation in patients with EoE...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28375450/patient-reported-outcome-measures-in-dysphagia-a-systematic-review-of-instrument-development-and-validation
#15
D A Patel, R Sharda, K L Hovis, E E Nichols, N Sathe, D F Penson, I D Feurer, M L McPheeters, M F Vaezi, David O Francis
OBJECTIVE: Patient-reported outcome (PRO) measures are commonly used to capture patient experience with dysphagia and to evaluate treatment effectiveness. Inappropriate application can lead to distorted results in clinical studies. A systematic review of the literature on dysphagia-related PRO measures was performed to (1) identify all currently available measures and (2) to evaluate each for the presence of important measurement properties that would affect their applicability. DESIGN: MEDLINE via the PubMed interface, the Cumulative Index of Nursing and Allied Health Literature, and the Health and Psychosocial Instrument database were searched using relevant vocabulary terms and key terms related to PRO measures and dysphagia...
May 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28366582/association-between-atopic-manifestations-and-eosinophilic-esophagitis-a-systematic-review-and-meta-analysis
#16
Jesús González-Cervera, Ángel Arias, Olga Redondo-González, María M Cano-Mollinedo, Ingrid Terreehorst, Alfredo J Lucendo
BACKGROUND: Eosinophilic esophagitis (EoE) has repeatedly been associated with atopic manifestations, which are reported more frequently in these patients than in the general population. OBJECTIVE: To systematically assess the evidence and strength of the associations between EoE and atopy. METHODS: We performed a systematic search of the MEDLINE, EMBASE, and SCOPUS databases for case-control studies comparing the frequency of atopic diatheses among patients with EoE and control subjects representing the general population without EoE...
May 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28366483/biologic-therapies-for%C3%A2-immunoglobulin-e-mediated-food-allergy-and-eosinophilic-esophagitis
#17
REVIEW
Iris M Otani, Kari C Nadeau
Immunoglobulin (Ig) E-mediated food allergy and eosinophilic esophagitis (EoE) are chronic, allergen-mediated disorders characterized by an aberrant TH2 immune response. The development and investigation of biologics for the treatment of IgE-mediated food allergy and eosinophilic esophagitis have provided further insight into the pathophysiology and management of these disorders. This article provides an overview of biologic therapies that are being investigated or have potential as treatments for IgE-mediated food allergy and eosinophilic esophagitis...
May 2017: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/28360963/assessing-eosinophilic-cationic-protein-as-a-biomarker-for-monitoring-patients-with-eosinophilic-esophagitis-treated-with-specific-exclusion-diets
#18
Joan Doménech Witek, Vicente Jover Cerdà, Vicente Gil Guillén, Juan Bautista Doménech Clar, Ramón Rodríguez Pacheco
BACKGROUND: Eosinophilic esophagitis (EoE) is a complex pathology. Attempts have been made in order to relate EoE with the intake of certain food. The problem is to establish which foods are really involved in the pathophysiology of this condition and to objectify a reliable inflammation biomarker for the follow-up of patients undergoing pharmacological treatment and/or diets. Our aim is to assess the food sensitization profile of patients with objective diagnosis of EoE and objectify the utility of ECP as an inflammation biomarker for the follow-up of patients with EoE treated with specific diets, based on the hypothesis that we will observe a decrease and clinical improvement after maintenance of these diets...
2017: World Allergy Organization Journal
https://www.readbyqxmd.com/read/28333765/adherence-to-celiac-disease-and-eosinophilic-esophagitis-biopsy-guidelines-is-poor-in-children
#19
Thomas Wallach, Robert M Genta, Benjamin Lebwohl, Peter H R Green, Norelle R Reilly
OBJECTIVES: Celiac disease (CD) and eosinophilic esophagitis (EoE) are underdiagnosed gastrointestinal conditions which adversely impact children's health. Prior studies have shown that diagnostic guidelines for CD are not consistently followed in adults. The aims of this study are to assess the frequency with which endoscopists comply with diagnostic guidelines for CD and EoE in children, and to determine whether an association exists between adherence to biopsy guidelines and disease detection in pediatric patients...
March 22, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28296675/eosinophilic-esophagitis-and-esophageal-granular-cell-tumor-an-unexpected-association
#20
Mary Ellen Riffle, Alexandros D Polydorides, Jessica Niakan, Mirna Chehade
Esophageal granular cell tumors (GCTs) are rare. Eosinophilic esophagitis (EoE) is an immune-mediated disease characterized by esophageal eosinophilia despite proton pump inhibitor (PPI) therapy. Given that GCTs occur at sites of scarring and inflammation, we sought to determine the prevalence of EoE in patients with esophageal GCTs. Our center's pathology database was searched for GCT specimens from 1995 to 2014. Slides were blindly rereviewed. GCTs were scored for atypical cytological features. Presence and number of eosinophils in the tumor and the surrounding esophageal epithelium and any EoE features were recorded...
May 2017: American Journal of Surgical Pathology
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