Management of eosinophilic esophagitis associated food impaction in Europe and the United States.

Details

Serval ID
serval:BIB_22D1BE680162
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Management of eosinophilic esophagitis associated food impaction in Europe and the United States.
Journal
Diseases of the esophagus
Author(s)
Schreiner P., Safroneeva E., Schoepfer A., Greuter T., Biedermann L., Schlag C., Labenz J., Auth MKH, Bredenoord A.J., Chang J.W., Bonis P.A., Rothenberg M.E., Collins M.H., Hirano I., Gupta S.K., Katzka D.A., Dellon E.S., Straumann A., Furuta G.T., Gonsalves N.
ISSN
1442-2050 (Electronic)
ISSN-L
1120-8694
Publication state
Published
Issued date
14/09/2022
Peer-reviewed
Oui
Volume
35
Number
9
Pages
doac003
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
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.
Keywords
Adult, Biopsy, Child, Endoscopy, Gastrointestinal, Enteritis, Eosinophilia, Eosinophilic Esophagitis/complications, Eosinophilic Esophagitis/therapy, Gastritis, Humans, United States, eosinophilic esophagitis, esophageal food impaction, esophagus
Pubmed
Web of science
Open Access
Yes
Create date
27/09/2022 15:07
Last modification date
07/10/2023 6:57
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