Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults (original) (raw)
2017, United European gastroenterology journal
Eosinophilic esophagitis (EoE) is one of the most prevalent esophageal diseases and the leading cause of dysphagia and food impaction in children and young adults. This underlines the importance of optimizing diagnosys and treatment of the condition, especially after the increasing amount of knowledge on EoE recently published. Therefore, the UEG, EAACI ESPGHAN, and EUREOS deemed it necessary to update the current guidelines regarding conceptual and epidemiological aspects, diagnosis, and treatment of EoE. General methodology according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used in order to comply with current standards of evidence assessment in formulation of recommendations. An extensive literature search was conducted up to August 2015 and periodically updated. The working group consisted of gastroenterologists, allergists, pediatricians, otolaryngologists,...
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BackgroundEosinophilic oesophagitis (EoE) is an increasingly common cause of dysphagia in both children and adults, as well as one of the most prevalent oesophageal diseases with a significant impact on physical health and quality of life. We have provided a single comprehensive guideline for both paediatric and adult gastroenterologists on current best practice for the evaluation and management of EoE.MethodsThe Oesophageal Section of the British Society of Gastroenterology was commissioned by the Clinical Standards Service Committee to develop these guidelines. The Guideline Development Group included adult and paediatric gastroenterologists, surgeons, dietitians, allergists, pathologists and patient representatives. The Population, Intervention, Comparator and Outcomes process was used to generate questions for a systematic review of the evidence. Published evidence was reviewed and updated to June 2021. The Grading of Recommendations, Assessment, Development and Evaluation (GRAD...
Eosinophilic esophagitis in pediatric age, state of the art and review of the literature
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Eosinophilic esophagitis (EoE) is a chronic immune-mediated relapsing disease caused by eosinophilic infiltration of the esophageal mucosa which is normally lacking these cells. EoE belongs to the group of the so called Eosinophilic Gastrointestinal Disorders (EGIDs). From a rare and unusual disease, EoE has become an emerging entity and in recent years its incidence and prevalence have increased all over the world, also in children. The pathogenesis is very complex and still not completely clear. Esophageal disfunction symptoms (e.g. dysphagia and food impaction) represent the typical manifestation of EoE and this condition could be difficult to recognize, more in pediatric age than in adults. Moreover, symptoms can often overlap with those of gastro-esophageal reflux disease (GERD), leading to a delayed diagnosis. EoE is often related to atopy and an allergological evaluation is recommended. Untreated EoE could provoke complications such as strictures, esophageal rings, narrowing ...
Eosinophilic esophagitis in children – current state of the problem
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In recent years, eosinophilic esophagitis (EE) has become a general clinical problem for allergists and gastroenterologists. The prevalence of EE is two times more likely to occur in children than in adults. Despite the large number of studies, it is considered that the aetiology and pathogenesis of EE have not been completely determined. The peculiarity of EE is that inflammatory changes are focal and evenly cover the distal and proximal oesophagus. During the allergic inflammatory process of the epithelium the oesophagus acquires hyperplastic characteristics, which causes the accumulation of eosinophils within it. The clinical picture of EE is nonspecific and varies according to the child’s age and the degree of progression of the disease. It is known that the onset of EE in children or adolescents subsequently leads to the need for endoscopic and surgical correction of dysphagia, strictures, narrowing of the oesophagus in a low number of these patients.
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