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2017 ; 5
(3
): 335-358
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Guidelines on eosinophilic esophagitis: evidence-based statements and
recommendations for diagnosis and management in children and adults
#MMPMID28507746
Lucendo AJ
; Molina-Infante J
; Arias Á
; von Arnim U
; Bredenoord AJ
; Bussmann C
; Amil Dias J
; Bove M
; González-Cervera J
; Larsson H
; Miehlke S
; Papadopoulou A
; Rodríguez-Sánchez J
; Ravelli A
; Ronkainen J
; Santander C
; Schoepfer AM
; Storr MA
; Terreehorst I
; Straumann A
; Attwood SE
United European Gastroenterol J
2017[Apr]; 5
(3
): 335-358
PMID28507746
show ga
INTRODUCTION: 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. METHODS: 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, pathologists, and epidemiologists. Systematic evidence-based
reviews were performed based upon relevant clinical questions with respect to
patient-important outcomes. RESULTS: The guidelines include updated concept of
EoE, evaluated information on disease epidemiology, risk factors, associated
conditions, and natural history of EoE in children and adults. Diagnostic
conditions and criteria, the yield of diagnostic and disease monitoring
procedures, and evidence-based statements and recommendation on the utility of
the several treatment options for patients EoE are provided. Recommendations on
how to choose and implement treatment and long-term management are provided based
on expert opinion and best clinical practice. CONCLUSION: Evidence-based
recommendations for EoE diagnosis, treatment modalities, and patients' follow up
are proposed in the guideline.