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Management of eosinophilic esophagitis associated food impaction in Europe and the United States.
Schreiner, Philipp; Safroneeva, Ekaterina; Schoepfer, Alain; Greuter, Thomas; Biedermann, Luc; Schlag, Christoph; Labenz, Joachim; Auth, Marcus K H; Bredenoord, Albert J; Chang, Joy W; Bonis, Peter A; Rothenberg, Marc E; Collins, Margaret H; Hirano, Ikuo; Gupta, Sandeep K; Katzka, David A; Dellon, Evan S; Straumann, Alex; Furuta, Glenn T; Gonsalves, Nirmala.
Afiliação
  • Schreiner P; Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland.
  • Safroneeva E; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
  • Schoepfer A; Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland.
  • Greuter T; Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland.
  • Biedermann L; Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland.
  • Schlag C; Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland.
  • Labenz J; Department of Medicine, Diakonie Hospital Jung- Stilling, Siegen, Germany.
  • Auth MKH; Alder Hey Children's NHS Foundation Trust and University of Liverpool, Liverpool, UK.
  • Bredenoord AJ; Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
  • Chang JW; Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
  • Bonis PA; Division of Gastroenterology, Tufts University School of Medicine, Boston, MA, USA.
  • Rothenberg ME; Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
  • Collins MH; Division of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
  • Hirano I; Division of Gastroenterology and Hepatology, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA.
  • Gupta SK; Division of Pediatric Gastroenterology, Hepatology and Nutrition, Riley Hospital for Children, Indiana University/Community Health Network, Indianapolis, IN, USA.
  • Katzka DA; Division of Gastroenterology, Mayo Clinic, Rochester, MN, USA.
  • Dellon ES; Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
  • Straumann A; Department of Gastroenterology & Hepatology, University Hospital Zurich, Zurich, Switzerland.
  • Furuta GT; Digestive Health Institute, Children's Hospital Colorado, Aurora, Colorado and Gastrointestinal Eosinophilic Diseases Program, University of Colorado School of Medicine, Aurora, CO, USA.
  • Gonsalves N; Division of Gastroenterology and Hepatology, Northwestern University-Feinberg School of Medicine, Chicago, IL, USA.
Dis Esophagus ; 35(9)2022 Sep 14.
Article em En | MEDLINE | ID: mdl-35088073
ABSTRACT
Eosinophilic esophagitis (EoE) is the most common cause of esophageal food impaction (EFI). Approaches to management of EFI due to EoE have not been well characterized. We conducted a web-based survey to understand approaches to management of EFI due to EoE among endoscopists. Questions focused on management of patients from presentation to post-endoscopy follow-up. The survey was administered to a list of eligible candidates provided by societies of gastroenterology. A total of 308 endoscopists completed the questionnaire. The majority (83%) practiced in Europe and treated adults (78%). Most agreed patients should be advised to seek emergency care (66%) within 1 to 2 hours (41% agreement). There was agreement that medications to induce vomiting should be avoided (84%) and that blood tests or imaging studies were usually not required before endoscopy. By contrast, there was more variability in the type of sedation recommended and the need for endotracheal intubation, especially when comparing more experienced with less experienced EoE-endoscopists. Overall, fewer than half (43%) respondents recommended obtaining esophageal biopsies during the initial endoscopy. However, there were significant differences in the proportion who recommended biopsies based on level of EoE-experience (25, 52, 77%, P < 0.001; less vs. moderate vs. very experienced) and comparing pediatric and adult endoscopists (32, vs. 79%, P < 0.001; adult vs. pediatric). There exists heterogeneity among endoscopists in recommendations to manage EFI in patients with EoE. These findings support development of clinical guidelines and new studies to clarify the rationale for best practices. Key

summary:

Established knowledge-The optimal management of patients with esophageal food impaction due to eosinophilic esophagitis from presentation at the emergency department to postendoscopy care is unclear. New findings-Considerable recommendation variation exists in the management of EFI in patients with EoE. Our findings provide a rationale for the creation of consensus practice guidelines and further study into best practices.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Esofagite Eosinofílica Tipo de estudo: Guideline / Qualitative_research / Risk_factors_studies Limite: Adult / Child / Humans País como assunto: America do norte Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Esofagite Eosinofílica Tipo de estudo: Guideline / Qualitative_research / Risk_factors_studies Limite: Adult / Child / Humans País como assunto: America do norte Idioma: En Ano de publicação: 2022 Tipo de documento: Article