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https://www.readbyqxmd.com/read/28536485/management-of-refractory-eosinophilic-oesophagitis
#1
REVIEW
Evan S Dellon
The goal of this Review is to discuss the clinical approach to patients who do not respond to treatment for eosinophilic oesophagitis (EoE). Refractory EoE is challenging to manage as there are limited data to guide decision-making. In this Review, refractory EoE is defined as persistent eosinophilia in the setting of incomplete resolution of the primary presenting symptoms and incomplete resolution of endoscopic findings following a PPI trial, and after treatment with either topical steroids or dietary elimination...
May 24, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28513085/systematic-review-with-meta-analysis-endoscopic-dilation-is-highly-effective-and-safe-in-children-and-adults-with-eosinophilic-oesophagitis
#2
REVIEW
F J Moawad, J Molina-Infante, A J Lucendo, S E Cantrell, L Tmanova, K M Douglas
BACKGROUND: Oesophageal dilation is frequently used as an adjunct treatment to alleviate symptoms that develop from fibrostenotic remodelling in eosinophilic oesophagitis (EoE). Earlier reports described an increased risk of complications associated with dilation. AIM: Perform a systematic review and meta-analysis to assess the efficacy and safety of endoscopic dilation in children and adults with EoE. METHODS: Professional librarians searched MEDLINE, EMBASE, the Cochrane library, Scopus, and Web of Science for articles in any language describing studies of dilation in EoE through December 2016...
May 17, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28502417/analysis-of-bronchial-biopsies-in-chronic-cough
#3
Patricia Macedo, Qingling Zhang, Junpei Saito, Zhike Liang, Lorrette Ffolkes, Andrew G Nicholson, Kian Fan Chung
BACKGROUND: Chronic cough is commonly associated with asthma, gastro-oesophageal reflux disease and postnasal drip, but in a significant proportion, no associated cause can be found. We determined whether examination of bronchial biopsies would be useful in determining the cause associated with chronic cough. METHODS: 100 consecutive patients referred to a specialist cough clinic underwent a systematic assessment including a fiberoptic bronchoscopy for bronchial biopsies...
June 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28470372/food-allergy-in-south-africa
#4
REVIEW
Claudia L Gray
PURPOSE OF THE REVIEW: Whilst food allergy seems to have increased significantly in many developed countries in the past few decades, quality data on the burden of food allergy in many developing countries is scanty. Until recently, South Africa had a dearth of robustly designed food allergy studies. This article summarizes some of the recent research and observations regarding food allergy from the South African setting. RECENT FINDINGS: South Africa has recently seen two important food allergy prevalence studies in selected and unselected populations...
June 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28404554/oesophageal-eosinophilia-in-children-with-coeliac-disease
#5
Anne Ari, Sara Morgenstern, Gabriel Chodick, Manar Matar, Ari Silbermintz, Amit Assa, Yael Mozer-Glassberg, Firas Rinawi, Vered Nachmias-Friedler, Raanan Shamir, Noam Zevit
OBJECTIVES: An association between coeliac disease (CD) and eosinophilic oesophagitis (EoE)/oesophageal eosinophilia (EE) has been suggested. We sought to characterise children with CD+EE in-depth and assess the contribution of each condition to the clinical presentation and treatment response. STUDY DESIGN: Medical records of children with both CD+EE, or isolated EoE diagnosed between 2000 and 2014, were retrospectively reviewed and compared with patients with isolated CD or epigastric pain...
April 12, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28370355/a-visual-analogue-scale-and-a-likert-scale-are-simple-and-responsive-tools-for-assessing-dysphagia-in-eosinophilic-oesophagitis
#6
C C Reed, W A Wolf, C C Cotton, E S Dellon
BACKGROUND: While symptom scores have been developed to evaluate dysphagia in eosinophilic oesophagitis (EoE), their complexity may limit clinical use. AIM: To evaluate a visual analogue scale (VAS) and a 10-point Likert scale (LS) for assessment of dysphagia severity before and after EoE treatment. METHODS: We conducted a prospective cohort study enrolling consecutive adults undergoing out-patient endoscopy. Incident cases of EoE were diagnosed per consensus guidelines...
June 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28339136/eosinophilic-esophagitis-phenotypes-ready-for-prime-time
#7
REVIEW
Dan Atkins, Glenn T Furuta, Chris A Liacouras, Jonathan M Spergel
Eosinophilic esophagitis (EoE) is one of the most common causes of reflux-like symptoms and feeding problems in children and food impaction and dysphagia in adults with a prevalence of 1:2500. Therapeutic options include diet, use of swallowed corticosteroids, or dilation. In the last several years, recent clinical and translational researches have identified some common and distinctive features, for example, the varying response to diet and medications. As EoE shares some characteristics with both asthma and inflammatory bowel disease, the advances in these fields suggest that various phenotypes may also exist in patients with EoE...
March 24, 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/28326578/editorial-elemental-diets-for-eosinophilic-oesophagitis
#8
EDITORIAL
D A Katzka
No abstract text is available yet for this article.
April 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28326569/the-dynamics-of-the-oesophageal-squamous-epithelium-normalisation-process-in-patients-with-gastro-oesophageal-reflux-disease-treated-with-long-term-acid-suppression-or-anti-reflux-surgery
#9
RANDOMIZED CONTROLLED TRIAL
L Mastracci, R Fiocca, C Engström, S Attwood, C Ell, J P Galmiche, J G Hatlebakk, G Långström, S Eklund, T Lind, L Lundell
BACKGROUND: Proton pump inhibitors and laparoscopic anti-reflux surgery (LARS) offer long-term symptom control to patients with gastro-oesophageal reflux disease (GERD). AIM: To evaluate the process of 'normalisation' of the squamous epithelium morphology of the distal oesophagus on these therapies. METHODS: In the LOTUS trial, 554 patients with chronic GERD were randomised to receive either esomeprazole (20-40 mg daily) or LARS. After 5 years, 372 patients remained in the study (esomeprazole, 192; LARS, 180)...
May 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28126881/eosinophilic-oesophagitis-an-insidious-but-treatable-cause-of-sore-throat
#10
Carla J Swift, John Ong
No abstract text is available yet for this article.
February 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28112427/elemental-diet-decreases-inflammation-and-improves-symptoms-in-adult-eosinophilic-oesophagitis-patients
#11
M J Warners, B J Vlieg-Boerstra, J Verheij, B D van Rhijn, M T J Van Ampting, L F Harthoorn, W J de Jonge, A J P M Smout, A J Bredenoord
BACKGROUND: Eosinophilic oesophagitis (EoE) is a chronic disease, driven by food allergens. Elemental diets are effective for the management of children with EoE, but studies on the effect of elemental diets in adults are scarce and poor palatability challenges dietary adherence. AIM: To assess the effects of an elemental diet (Neocate, Nutricia, Utrecht, the Netherlands) on the inflammation, symptoms and endoscopic signs in adult EoE patients. METHODS: In this prospective study, 21 patients with active EoE, confirmed by biopsies showing ≥15 eosinophils per microscopic high power field (HPF) and symptoms of oesophageal dysfunction were included...
March 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27921303/eosinophils-from-eosinophilic-oesophagitis-patients-have-t-cell-suppressive-capacity-and-express-foxp3
#12
C Lingblom, J Wallander, M Ingelsten, H Bergquist, M Bove, R Saalman, A Welin, C Wennerås
Eosinophilic esophagitis (EoE) is an antigen-driven T cell-mediated chronic inflammatory disease where food and environmental antigens are thought to have a role. Human eosinophils express the immunoregulatory protein galectin-10 and have T cell suppressive capacity similar to regulatory T cells (Tregs ). We hypothesized that one function of eosinophils in EoE might be to regulate the T cell-driven inflammation in the oesophagus. This was tested by evaluating the suppressive capacity of eosinophils isolated from the blood of adult EoE patients in a mixed lymphocyte reaction...
March 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/27896821/clinical-symptom-tool-that-raises-the-index-of-suspicion-for-eosinophilic-oesophagitis-in-adults-and-drives-earlier-biopsy-for-definitive-diagnosis
#13
U von Arnim, F-W Röhl, S Miehlke, D Jechorek, D Reinhold, T Wex, P Malfertheiner
BACKGROUND: Eosinophilic oesophagitis (EoE) and gastro-oesophageal reflux disease (GERD) present with overlapping symptomatology and it is challenging to distinguish EoE from GERD clinically before endoscopy. AIM: To investigate the prognostic value of a set of clinical symptoms and laboratory values in patients with EoE and GERD. METHODS: In this prospective, single-centre, observational study, we compared clinical and laboratory data from 202 patients with EoE or GERD (10 relevant characteristics)...
February 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27888864/oesophageal-disease-gastroesophageal-reflux-disease-barrett-s-oesophagus-achalasia-and-eosinophilic-oesophagitis
#14
Xavier Calvet
The most interesting conclusions and/or advances presented at Digestive Disease Week 2016 were the following: a) gastroesophageal reflux disease: proton pump inhibitor-refractory reflux disease is frequently associated with poor treatment adherence, psychiatric comorbidities and functional gastrointestinal disorders. These possible entities should be investigated in all cases of proton pump inhibitor-refractory reflux disease; b) Barrett's oesophagus: the efficacy of screening remains unclear; however, new minimally-invasive techniques such as the cytosponge allow more effective detection, both of Barrett's oesophagus and Barrett's oesophagus-associated dysplasia or neoplasia; c) achalasia: evidence indicates that peroral endoscopic myotomy is as effective as surgery and is a safer alternative; d) eosinophilic oesophagitis: high-dose proton pump inhibitors are required to rule out proton pump inhibitor-responsive eosinophilic oesophagitis; montelukast is not clearly effective in the treatment of eosinophilic oesophagitis, although moderate efficacy cannot be ruled out...
September 2016: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/27878833/presence-of-intraepithelial-food-antigen-in-patients-with-active-eosinophilic-oesophagitis
#15
E V Marietta, D M Geno, T C Smyrk, A Becker, J A Alexander, M Camilleri, J A Murray, D A Katzka
BACKGROUND: Although eosinophilic oesophagitis (EoE) is putatively mediated by an abnormal response to food antigen, the oesophagus is considered relatively impermeable to large molecules. AIM: To assess whether food antigens penetrate the oesophageal mucosa in patients with EoE. METHODS: Anti-gliadin staining was performed in three groups: active EoE, inactive EoE and EoE patients on a low or gluten free diet. To appraise the specificity of our results, we also performed gliadin staining on six patients without oesophageal disease who were consuming gluten...
February 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27868307/effects-of-eosinophilic-oesophagitis-on-quality-of-life-in-an-adult-uk-population-a-case-control-study
#16
R Hewett, C Alexakis, A D Farmer, J Ainley, V Chhaya, J O Hayat, A Poullis, J-Y Kang
Eosinophilic oesophagitis (EoE) is a chronic immune-mediated esophageal disease, characterized by symptoms related to esophageal dysfunction and histologically by eosinophil predominant inflammation. Current evidence for an adverse impact on quality of life (QoL) is conflicting and there are no data from a UK population regarding QoL. We conducted a prospective cross-sectional observational study using the Short Form-36 Health Survey, Hospital Dysphagia/Odynophagia Questionnaire, and the EoE Adult Quality of Life Questionnaire to assess QoL and severity of dysphagia in EoE patients, compared to age and gender matched healthy control subjects...
January 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/27868216/the-endoscopic-reference-score-shows-modest-accuracy-to-predict-either-clinical-or-histological-activity-in-adult-patients-with-eosinophilic-oesophagitis
#17
J Rodríguez-Sánchez, J Barrio-Andrés, O Nantes Castillejo, E Valdivieso-Cortazar, I Pérez-Martínez, A Boumidi, J A Olmos-Jérez, G Payeras-Llodra, N Alcaide-Suarez, L Ruiz-Rebollo, B Madrigal-Rubiales, E Gonzalez-Obeso, E de la Santa Belda, B López Viedma, J Molina-Infante
BACKGROUND: Conflicting results have been recently reported for the accuracy of the Endoscopic Reference Score (EREFS), an standardised endoscopic classification, to predict the histological activity of eosinophilic oesophagitis (EoE). AIM: To evaluate the accuracy of the EREFS to predict either histological or clinical activity of EoE. METHODS: Prospective multicentre study conducted in eight Spanish centres evaluating adult EoE patients, either naïve or after treatment...
January 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27758725/-dysphagia-in-children
#18
E Ten Velde, B C Gonera-de Jong
In this case report we discuss two children with dysphagia. Both presented with difficulties in swallowing and oesophageal impaction of solid food. The first case involves a 16-year-old boy who suffered from dysphagia for many years. After a long diagnostic journey, during which a psychogenic cause was suspected, he was diagnosed with oesophageal achalasia. After a balloon dilatation of the lower oesophageal sphincter his complaints persisted and the treatment procedure was repeated. The second case involves a 15-year-old girl, who presented with a food impaction in the distal oesophagus...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27605525/the-role-of-microaspiration-in-the-pathogenesis-of-gastroesophageal-reflux-related-chronic-cough
#19
Pelin Özdemir, Münevver Erdinç, Rukiye Vardar, Ali Veral, Serdar Akyıldız, Özer Özdemir, Serhat Bor
Background/Aims: Gastroesophageal reflux disease (GERD) is one of the main causes of chronic cough. We evaluated the role of microaspiration in the pathogenesis of reflux-related cough by determining the amount of lipid-laden macrophages (LLMs) in bronchoalveolar lavage (BAL) specimens. Methods: A total of 161 cases of chronic cough were evaluated, and 36 patients (average age 48.2 years) were recruited for this single center prospective study. Patients with a history of smoking, angiotensin converting enzyme inhibitor usage, any abnormality on pulmonary function tests, abnormal chest X-rays, occupational or environmental exposures, or upper airway cough syndrome were excluded...
January 30, 2017: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/27592279/primary-eosinophilic-gastrointestinal-disorders-in-children-who-have-received-food-oral-immunotherapy
#20
L Á Echeverría-Zudaire, S Fernández-Fernández, A Rayo-Fernández, C Muñóz-Archidona, R Checa-Rodriguez
BACKGROUND: Food oral immunotherapy (OIT) involves the administration of the food allergen causing the symptoms, in order to induce tolerance. Primary eosinophilic gastrointestinal disorders (PEGDs) are characterised by an eosinophil-rich inflammation affecting different locations of the digestive tract. We present a series of patients with PEGDs in a group of children following OIT with milk and/or egg. MATERIAL AND METHODS: A prospective study during the period 2006-2014 was performed in paediatric patients subjected to OIT with milk and/or egg...
November 2016: Allergologia et Immunopathologia
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