Alfredo J Lucendo1,2, Javier Molina-Infante2,3, Ángel Arias2,4, Ulrike von Arnim5, Albert J Bredenoord6, Christian Bussmann7, Jorge Amil Dias8, Mogens Bove9, Jesús González-Cervera2,10, Helen Larsson9, Stephan Miehlke11, Alexandra Papadopoulou12, Joaquín Rodríguez-Sánchez13, Alberto Ravelli14, Jukka Ronkainen15, Cecilio Santander2,16, Alain M Schoepfer17, Martin A Storr18, Ingrid Terreehorst19, Alex Straumann20, Stephen E Attwood21. 1. Department of Gastroenterology, Hospital General de Tomelloso, Servicio de Salud de Castilla-La Mancha, Tomelloso, Spain. 2. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain. 3. Department of Gastroenterology, Hospital San Pedro de Alcantara, Caceres, Spain. 4. Research Support Unit, Hospital General Mancha Centro, Alcázar de San Juan, Spain. 5. Department of Gastroenterology, Hepatology and Infectious Diseases, Otto von Guericke University, Magdeburg, Germany. 6. Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, the Netherlands. 7. Pathologie Viollier, Basel, Switzerland. 8. Department of Pediatrics, Hospital S. João, Porto, Portugal. 9. Department of ENT, Head and Neck Surgery, NÄL Medical Centre, Trollhättan, Sweden. 10. Department of Allergy, Hospital General de Tomelloso, Tomelloso, Spain. 11. Center for Digestive Diseases, Internal Medicine Center Eppendorf, Hamburg, Germany. 12. Division of Pediatric Gastroenterology and Hepatology, Athens Children's Hospital "Agia Sofia", University of Athens, Athens, Greece. 13. Department of Gastroenterology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain. 14. University Department of Pediatrics, Children's Hospital - Spedali Civili, Brescia, Italy. 15. Center for Life Course Health Research, University of Oulu, Tornio, Finland. 16. Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain. 17. Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois et Université de Lausanne, Lausanne, Switzerland. 18. Center of Endoscopy, Starnberg, Germany. 19. Department of ENT, Amsterdam Medical Centre, Amsterdam, the Netherlands. 20. Swiss EoE Clinics, Olten, Switzerland. 21. Department of Health Services Research, Durham University, UK.
Abstract
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.
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.
Entities:
Keywords:
Eosinophilic esophagitis; consensus development conferences; evidence-based practice; guidelines
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