Diagnosis
Treatment
Treatment Response
Summary
Diagnosis
Treatment
Treatment Response
Summary
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Diagnosis
Treatment
Treatment Response
Summary
Symptoms
Endoscopic
Assessment
Histologic
Assessment
Exclusion of
Non-EoE Disorders
Diagnosis
Treatment
Treatment Response
Summary
Symptoms
Difficulty swallowing, chest pains, and comorbidity of food allergy to shellfish all reflect a clinical presentation suggestive of EoE
Endoscopic Assessment
Recent food impaction and EREFS total score of 5 out of 8 reflect upper endoscopic findings, which increase suspicion for EoE
Histologic Assessment
Esophageal eosinophilia of 40 eos/hpf is above the 15 eos/hpf threshold necessary to confirm EoE diagnosis
Exclusion of
Non-EoE Disorders
Lack of GERD excludes a common non-EoE disorder that may be present in patients with EoE
Diagnosis
Treatment
Treatment Response
Summary
Diagnosis
Treatment
Treatment Response
Summary
Diagnosis
Treatment
Treatment Response
Summary
Proton
Pump
Inhibitor
Swallowed
Topical
Corticosteroid
Empiric
Elimination
Diet
Elemental
Diet
Esophageal
Dilation
Diagnosis
Treatment
Treatment Response
Summary
Diagnosis
Treatment
Treatment Response
Summary
Proton
Pump
Inhibitor
Swallowed
Topical
Corticosteroid
Empiric
Elimination
Diet
Elemental
Diet
Esophageal
Dilation
Diagnosis
Treatment
Treatment Response
Summary
Histology
Symptoms
Endoscopy
Diagnosis
Treatment
Treatment Response
Summary
Histology
The only currently available quantitative threshold of adequate therapeutic response is defined as <15 eos/hpf in esophageal mucosa1,2
Additional prospective,
long-term studies are needed to confirm that reduction in esophageal eosinophilia prevents progressive disease remodeling2
Symptoms
Symptom assessment can be challenging due to use of non-validated instruments and behavioral adaptations that mask symptoms1,2
Symptoms do not correlate accurately with histologic disease activity1
EoE activity should not be assessed based only on symptoms1
Endoscopy
Endoscopic esophageal biopsies continue to be necessary to accurately monitor disease activity1
Follow-up endoscopy after a
6-to-12-week course of treatment has been suggested; however, the recommended frequency of EGD with biopsy during clinical follow-up may vary1,2
Although disease remission is currently anchored
in histologic criteria, symptoms and pathology outcomes are often discordant with one another1,2
Comprehensive assessment of disease activity needs to include patient-reported symptom outcomes and objective measures of endoscopic findings1,2
Diagnosis
Treatment
Treatment Response
Summary
Daniel Did Not Achieve
Histologic Remission
(≥15 eos/hpf)
Daniel Achieved
Histologic Remission
(<15 eos/hpf)
With Persistent Symptoms
or Endoscopic Findings
Daniel Achieved
Histologic Remission
(<15 eos/hpf)
With Symptomatic
and Endoscopic Relief
Diagnosis
Treatment
Treatment Response
Summary
Diagnosis
Treatment
Treatment Response
Summary
Diagnosis
Treatment
Treatment Response
Summary
Diagnosis
Treatment
Treatment Response
Summary
Diagnosis
Treatment
Treatment Response
Summary
Diagnosis
Treatment
Treatment Response
Summary
Symptoms
Endoscopic Assessment
Histologic Assessment
Exclusion of
Non-EoE Disorders
Histology
Symptoms
Endoscopy
Maintenance Therapy
Diagnosis
Treatment
Treatment Response
Summary
Diagnosis
Treatment
Treatment Response
Summary
Diagnosis
Treatment
Treatment Response
Summary
Diagnosis
Treatment
Treatment Response
Summary
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