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Management of suspected and known eosinophilic esophagitis—a nationwide survey in Austria

作者:Philipp Schreiner, Lorenz Balcar, Hansjörg Schlager, Christian Madl, A Ziachehabi, Markus Mader, K Steidl, Patrick Dinkhauser, Simon Reider, Werner Dolak, Clemens Dejaco, Hans Peter Gröchenig, Gottfried Novacek · 发表于:Wiener klinische Wochenschrift · 年份:2023 · DOI:10.1007/s00508-023-02198-0 · 被引用次数:5 · 研究领域:Eosinophilic Esophagitis、Food Allergy and Anaphylaxis Research、Esophageal and GI Pathology

INTRODUCTION: Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease of the esophagus with increasing incidence and dysphagia as the main symptom. The management of suspected or known EoE by Austrian endoscopists has not been investigated yet. METHODS: A web-based survey with 13 questions about the management of EoE was sent to endoscopists via the Austrian Society of Gastroenterology and Hepatology (ÖGGH). RESULTS: A total of 222 endoscopists (74% gastroenterologists, 23% surgeons, and 2% pediatricians; 68% working in a hospital) from all 9 states participated. In patients with dysphagia but a normal appearing esophagus, 85% of respondents reported always taking biopsies; however, surgeons were less likely to obtain biopsies compared to gastroenterologists ("always" 69% vs. 90%, "sometimes" 29% vs. 10%, "never" 2% vs. 0%, p < 0.001). The approved budesonide orodispersible tablet is the preferred first-line drug used in EoE, ahead of proton pump inhibitors (PPI). Only 65% of participants monitor the patients by endoscopy and histology after 12 weeks of induction therapy, 26% do not continue maintenance therapy, and 22% monitor patients only when symptomatic. CONCLUSION: The vast majority of Austrian endoscopists adhere to the European and US guidelines in cases of suspected EoE. In contrast, despite the chronic disease course, a significant percentage of providers indicate not to use maintenance therapy and monitor the patients routinely.