Practice Differences in the Diagnosis and Management of Eosinophilic Esophagitis Among Adult and Pediatric Gastroenterologists in Israel.
J Pediatr Gastroenterol Nutr
; 67(1): 34-39, 2018 07.
Article
en En
| MEDLINE
| ID: mdl-29394215
ABSTRACT
OBJECTIVES:
Eosinophilic esophagitis (EoE) guidelines call for similar practices in adults and children with EoE. We compared the diagnostic and management practices of gastroenterologists treating adult and pediatric patients suspected of having, or diagnosed with, EoE.METHODS:
A 19-question multiple-choice questionnaire was given to gastroenterologists treating either adults or children. Questions explored 4 areas of interest physician demographics, diagnosis and tissue sampling practices, management, and the need for societal publications on EoE.RESULTS:
Completed questionnaires were returned by 85/180 adult and 30/40 pediatric gastroenterologists (PGs). Compared to PGs, adult gastroenterologists (AGs) took esophageal biopsies significantly less frequently in the following scenarios endoscopy without esophageal symptoms or macroscopic endoscopic findings (10% vs 57%; Pâ<â0.001), dysphagia without macroscopic findings (83% vs 100%; P = 0.019), and gastroesophageal reflux symptoms with distal esophageal erythema (44% vs 100%; Pâ<â0.001). Significantly fewer AGs reported taking gastric and duodenal biopsies when EoE was suspected (29% vs 90%; Pâ<â0.001). AGs more often followed patients clinically (30% vs 0%; Pâ<â0.001) rather than endoscopically, and were far less inclined to implement elimination diets compared to PGs (23% vs 68%; Pâ<â0.001).CONCLUSIONS:
Significant disparities exist between gastroenterologists treating adult and pediatric patients with EoE. These findings may impact rates of diagnosis, appropriate treatment, monitoring, long-term outcomes, and may affect negatively transition from pediatric to adult care.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Pediatría
/
Pautas de la Práctica en Medicina
/
Esofagitis Eosinofílica
/
Gastroenterología
Tipo de estudio:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
/
Qualitative_research
Límite:
Adult
/
Child
/
Female
/
Humans
/
Male
País/Región como asunto:
Asia
Idioma:
En
Revista:
J Pediatr Gastroenterol Nutr
Año:
2018
Tipo del documento:
Article