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https://www.readbyqxmd.com/read/28445189/proton-pump-inhibitor-responsive-esophageal-eosinophilia-still-a-valid-diagnosis
#1
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
#2
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/28439884/the-home-environment-shapes-emotional-eating
#3
Moritz Herle, Alison Fildes, Frühling Rijsdijk, Silje Steinsbekk, Clare Llewellyn
Emotional overeating (EOE) is the tendency to eat more in response to negative emotions; its etiology in early life is unknown. We established the relative genetic and environmental influences on EOE in toddlerhood and early childhood. Data were from Gemini, a population-based cohort of 2,402 British twins born in 2007. EOE was measured using the "emotional overeating" scale of the Child Eating Behavior Questionnaire (CEBQ) at 16 months and 5 years. A longitudinal quantitative genetic model established that genetic influences on EOE were minimal; on the other hand, shared environmental influences explained most of the variance...
April 25, 2017: Child Development
https://www.readbyqxmd.com/read/28429201/how-to-approach-lymphocytic-esophagitis
#4
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
#5
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
#6
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
#7
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/28404554/oesophageal-eosinophilia-in-children-with-coeliac-disease
#8
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/28402662/dominant-carbons-in-trans-and-cis-resveratrol-isomerization
#9
Feng Wang, Subhojyoti Chatterjee
A comprehensive analysis for isomerization of geometric isomers in the case of resveratrol (R) has been presented. As an important red wine molecule, only one geometric isomer of resveratrol, i.e., trans-R rather than cis-R, is primarily associated with health benefit. In the present study, density function theory (DFT) provides accurate descriptions of isomerization of resveratrol. The nearly planar trans-R forms a relatively rigid and less flexible conjugate network, but the nonplanar cis-R favors a more flexible structure with steric through space interaction...
April 26, 2017: Journal of Physical Chemistry. B
https://www.readbyqxmd.com/read/28383396/role-of-endoscopic-esophageal-dilation-in-managing-eosinophilic-esophagitis-a-systematic-review-and-meta-analysis
#10
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
#11
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/28370355/a-visual-analogue-scale-and-a-likert-scale-are-simple-and-responsive-tools-for-assessing-dysphagia-in-eosinophilic-oesophagitis
#12
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...
March 31, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28366582/association-between-atopic-manifestations-and-eosinophilic-esophagitis-a-systematic-review-and-meta-analysis
#13
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...
March 30, 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
#14
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
#15
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/28339136/eosinophilic-oesophagitis-phenotypes-ready-for-primetime
#16
REVIEW
Dan Atkins, Glenn T Furuta, Chris A Liacouras, Jonathan M Spergel
Eosinophilic Oesophagitis (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 research 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 suggests that various phenotypes may also exist in patients with EoE...
March 24, 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/28333765/adherence-to-celiac-disease-and-eosinophilic-esophagitis-biopsy-guidelines-is-poor-in-children
#17
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
#18
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
https://www.readbyqxmd.com/read/28294586/pediatric-eosinophilic-esophagitis-in-portugal
#19
J L Alves Marcelino, R Cardoso de Aguiar, F Cabral Duarte, A Célia Costa, M A Pereira-Barbosa
Eosinophilic esophagitis (EoE) is an increasingly frequent diagnosis in our clinical practice, mainly in pediatric age. Allergic responses to food and aeroallergens have been increasingly implicated in the etiology of this disease. We describe a retrospective data analysis of pediatric EoE patients followed in our Immunoallergology Department. Of the 25 children (22 male, average 10.8 years), 88% had prior history of rhinoconjunctivitis, 76% asthma, 48% eczema and 36% food allergy. After evaluation, we identified in 76% and 92% of patients food and aeroallergen sensitization, respectively; 68% had simultaneously food and inhalant sensitization and 96% had at least one positive test to aeroallergens or food allergens...
March 2017: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28291175/ppi-trial-for-eosinophilic-esophagitis-chaos-in-the-community
#20
Seth Lipka, Ambuj Kumar, Joel E Richter
INTRODUCTION: Despite consensus eosinophilic esophagitis (EoE) statement published in 2011 calling for a 2-month trial of protons pump inhibitor (PPI), the guidelines are not followed by many. We studied the practice patterns in our community and response to a PPI retrial in patients previously diagnosed with "idiopathic EoE." METHODS: All patients presenting to the senior author's practice with suspected EoE from 2011 to 2015. Two cohorts were studied: (1) patients diagnosed in the community as "idiopathic EoE"; (2) treatment naïve patients given a PPI trial at University of South Florida...
March 13, 2017: Journal of Clinical Gastroenterology
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