Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Apr;5(3):335-358.
doi: 10.1177/2050640616689525. Epub 2017 Jan 23.

Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults

Alfredo J Lucendo  1   2 , Javier Molina-Infante  2   3 , Ángel Arias  2   4 , Ulrike von Arnim  5 , Albert J Bredenoord  6 , Christian Bussmann  7 , Jorge Amil Dias  8 , Mogens Bove  9 , Jesús González-Cervera  2   10 , Helen Larsson  9 , Stephan Miehlke  11 , Alexandra Papadopoulou  12 , Joaquín Rodríguez-Sánchez  13 , Alberto Ravelli  14 , Jukka Ronkainen  15 , Cecilio Santander  2   16 , Alain M Schoepfer  17 , Martin A Storr  18 , Ingrid Terreehorst  19 , Alex Straumann  20 , Stephen E Attwood  21
Affiliations
Review

Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults

Alfredo J Lucendo et al. United European Gastroenterol J. 2017 Apr.

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.

Keywords: Eosinophilic esophagitis; consensus development conferences; evidence-based practice; guidelines.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Therapeutic algorithm proposed for eosinophilic esophagitis in clinical practice.
See this image and copyright information in PMC

Comment in

References

    1. Attwood SE, Smyrk TC, Demeester TRJJ. Esophageal eosinophilia with dysphagia. A distinct clinicopathologic syndrome. Dig Dis Sci 1993; 38: 109–116. - PubMed
    1. Straumann A, Spichtin HP, Bernoulli R, et al. Idiopathic eosinophilic esophagitis: a frequently overlooked disease with typical clinical aspects and discrete endoscopic findings. Schweiz Med Wochenschr 1994; 124: 1419–1429. - PubMed
    1. Furuta GT, Liacouras CA, Collins MH, et al. Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment. Gastroenterology 2007; 133: 1342–1363. - PubMed
    1. Liacouras CA, Furuta GT, Hirano I, et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol 2011; 128: 3–20. - PubMed
    1. Papadopoulou A, Koletzko S, Heuschkel R, et al. Management guidelines of eosinophilic esophagitis in childhood. J Pediatr Gastroenterol Nutr 2014; 58: 107–118. - PubMed