BOOK
Eosinophilic Esophagitis, An Issue of Gastrointestinal Endoscopy Clinics, E-Book
(2017)
Additional Information
Book Details
Abstract
Eosinophilic esophagitis is an important disease that causes considerable morbidity in those afflicted. It is a major cause of esophageal symptoms, particularly dysphagia. Eosinophilic esophagitis seems to be increasing in frequency like bronchial asthma, to which it has been compared. It is complex and may have more than one pathogenesis in its varying presentations in children and adults.Dr. Katzka has invited expert authors to write clinical reviews on this complicated disease. Articles are devoted to the following topics: Pathophysiology and Definition; Incidence and Prevalence; Demographic Features; Symptoms; Endoscopic and Radiologic Findings; Children vs. Adults; Pharmacologic Treatment; Dietary Treatment; Endoscopic Treatment; and Future Directions. Readers will have the current knowledge of the endoscopic approach to diagnosis and treatment of this disease.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Eosinophilic Esophagitis | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITOR | iii | ||
| AUTHORS | iii | ||
| Contents | v | ||
| Foreword: Eosinophilic Esophagitis: New Insights and Management | v | ||
| Preface: Eosinophilic Esophagitis | v | ||
| Eosinophilic Esophagitis: Pathophysiology and Definition | v | ||
| Eosinophilic Esophagitis: Incidence and Prevalence | v | ||
| Demographic Features of Eosinophilic Esophagitis | v | ||
| Latest Insights on the Relationship Between Symptoms and Biologic Findings in Adults with Eosinophilic Esophagitis | vi | ||
| Endoscopic and Radiologic Findings in Eosinophilic Esophagitis | vi | ||
| Eosinophilic Esophagitis in Children and Adults | vi | ||
| Pharmacologic Treatment of Eosinophilic Esophagitis: An Update | vi | ||
| Dietary Therapy in Eosinophilic Esophagitis | vii | ||
| Endoscopic Treatment of Eosinophilic Esophagitis | vii | ||
| Future Directions in Eosinophilic Esophagitis | vii | ||
| GASTROINTESTINAL ENDOSCOPY CLINICS\rOF NORTH AMERICA\r | viii | ||
| FORTHCOMING ISSUES | viii | ||
| April 2018 | viii | ||
| July 2018 | viii | ||
| October 2018 | viii | ||
| RECENT ISSUES | viii | ||
| October 2017 | viii | ||
| July 2017 | viii | ||
| April 2017 | viii | ||
| Foreword: Eosinophilic Esophagitis: New Insights and Management\r | ix | ||
| Preface:\rEosinophilic Esophagitis | xi | ||
| Eosinophilic Esophagitis | 1 | ||
| Key points | 1 | ||
| OVERVIEW | 1 | ||
| DEFINITION | 1 | ||
| CLINICAL SYMPTOMS | 3 | ||
| PATHOPHYSIOLOGY | 3 | ||
| Genetic Insights | 3 | ||
| EPIDEMIOLOGY AND ENVIRONMENT | 4 | ||
| Epithelial Pathobiology | 5 | ||
| EOSINOPHILS | 5 | ||
| T CELLS | 5 | ||
| REGULATORY T CELLS | 6 | ||
| INNATE NATURAL KILLER T CELLS AND TYPE 2 INNATE LYMPHOID | 6 | ||
| MAST CELLS | 6 | ||
| BASOPHILS | 6 | ||
| MAIN CHEMOKINES/CYTOKINES | 6 | ||
| Interleukin-13 | 6 | ||
| Interleukin-4 | 6 | ||
| Interleukin-5 | 7 | ||
| Eotaxin-3 | 7 | ||
| IgE and IgG4 | 7 | ||
| Thymic Stromal Lymphopoeitin | 7 | ||
| Fibrosis and Remodeling | 7 | ||
| SUMMARY | 8 | ||
| REFERENCES | 8 | ||
| Eosinophilic Esophagitis | 15 | ||
| Key points | 15 | ||
| INTRODUCTION | 15 | ||
| INCIDENCE OF EOSINOPHILIC ESOPHAGITIS | 16 | ||
| PREVALENCE OF EOSINOPHILIC ESOPHAGITIS | 18 | ||
| Eosinophilic Esophagitis Among Symptomatic Patients | 18 | ||
| Eosinophilic Esophagitis in Patients With Refractory Reflux | 19 | ||
| Eosinophilic Esophagitis in Patients With Dysphagia | 19 | ||
| Eosinophilic Esophagitis in Patients With Food Impaction | 19 | ||
| Eosinophilic Esophagitis in Population-Based Studies | 19 | ||
| Eosinophilic Esophagitis Associated With Other Conditions and Changes in Environments | 21 | ||
| SUMMARY | 21 | ||
| REFERENCES | 22 | ||
| Demographic Features of Eosinophilic Esophagitis | 27 | ||
| Key points | 27 | ||
| INTRODUCTION | 27 | ||
| AGE | 27 | ||
| GENDER | 28 | ||
| RACE | 28 | ||
| GEOGRAPHY | 29 | ||
| CLIMATE | 29 | ||
| ASSOCIATED DISORDERS | 30 | ||
| SUMMARY | 30 | ||
| REFERENCES | 30 | ||
| Latest Insights on the Relationship Between Symptoms and Biologic Findings in Adults with Eosinophilic Esophagitis | 35 | ||
| Key points | 35 | ||
| INTRODUCTION | 36 | ||
| THE TALE OF TWO STUDIES AND NONLINEAR RELATIONSHIP BETWEEN SYMPTOMS AND BIOLOGIC FINDINGS | 36 | ||
| DIAGNOSTIC DELAY IN EOSINOPHILIC ESOPHAGITIS | 38 | ||
| IMPLICATIONS FOR FUTURE TRIALS | 39 | ||
| LONG-TERM MANAGEMENT OF EOSINOPHILIC ESOPHAGITIS | 42 | ||
| SUMMARY (OR TWO STUDIES REVISITED) | 42 | ||
| REFERENCES | 43 | ||
| Endoscopic and Radiologic Findings in Eosinophilic Esophagitis | 47 | ||
| Key points | 47 | ||
| ENDOSCOPIC FINDINGS | 47 | ||
| Major Features | 48 | ||
| Exudates | 48 | ||
| Rings | 48 | ||
| Edema | 49 | ||
| Furrows | 49 | ||
| Stricture | 50 | ||
| Other Features | 51 | ||
| Crepe paper esophagus | 51 | ||
| Feline esophagus | 51 | ||
| Pull sign | 52 | ||
| Postdilation deep mucosal tears | 52 | ||
| Normal esophagus | 52 | ||
| Miscellaneous | 53 | ||
| RADIOGRAPHIC FINDINGS | 53 | ||
| Rings | 54 | ||
| Strictures | 54 | ||
| SUMMARY | 55 | ||
| REFERENCES | 55 | ||
| Eosinophilic Esophagitis in Children and Adults | 59 | ||
| Key points | 59 | ||
| INTRODUCTION | 59 | ||
| EPIDEMIOLOGIC ASPECTS OF EOSINOPHILIC ESOPHAGITIS | 60 | ||
| CLINICAL PRESENTATION | 61 | ||
| COMPARISON OF ATOPIC FEATURES BETWEEN CHILDREN AND ADULTS WITH EOSINOPHILIC ESOPHAGITIS | 62 | ||
| HISTOPATHOLOGICAL FEATURES | 62 | ||
| FIBROUS REMODELING OF THE ESOPHAGUS IN EOSINOPHILIC ESOPHAGITIS | 63 | ||
| TREATMENT OF PEDIATRIC AND ADULT PATIENTS | 63 | ||
| Initial Management | 63 | ||
| Corticosteroids | 63 | ||
| Dietary Therapy | 64 | ||
| Elemental Diet | 64 | ||
| Dietary Restriction | 65 | ||
| SUGGESTED APPROACH TO PATIENTS WITH EOSINOPHILIC ESOPHAGITIS: CHILDREN VERSUS ADULTS | 66 | ||
| PEDIATRIC PATIENTS | 67 | ||
| ADULT PATIENTS | 68 | ||
| SUMMARY | 71 | ||
| REFERENCES | 71 | ||
| Pharmacologic Treatment of Eosinophilic Esophagitis | 77 | ||
| Key points | 77 | ||
| INTRODUCTION | 78 | ||
| Definition of Eosinophilic Esophagitis | 78 | ||
| Pathophysiology and Natural History of Eosinophilic Esophagitis | 78 | ||
| Reasons to Treat Active Eosinophilic Esophagitis | 79 | ||
| How to Assess the Efficacy of a Pharmacologic Treatment | 79 | ||
| THERAPEUTIC OPTIONS FOR EOSINOPHILIC ESOPHAGITIS | 79 | ||
| Proton Pump Inhibitors | 80 | ||
| Swallowed Topical Corticosteroids: Budesonide, Fluticasone Propionate, Ciclesonide | 81 | ||
| Systemic Steroids | 82 | ||
| Azathioprine and Mercaptopurine | 82 | ||
| Antiallergic Drugs: Sodium Cromoglycate and Antihistamines | 83 | ||
| Biological Drugs | 83 | ||
| SUMMARY | 83 | ||
| REFERENCES | 84 | ||
| Dietary Therapy in Eosinophilic Esophagitis | 89 | ||
| Key points | 89 | ||
| INTRODUCTION | 89 | ||
| DIETARY THERAPY IN EOSINOPHILIC ESOPHAGITIS | 90 | ||
| Goals of Diet Therapy | 90 | ||
| RECENT LITERATURE | 90 | ||
| Effectiveness of Elemental Diets in Adults | 90 | ||
| Effectiveness of Allergy-Directed Diets | 91 | ||
| Effectiveness of Empiric Elimination Diets in Adults | 91 | ||
| Potential Development of Tolerance After Dietary Therapy | 92 | ||
| Potential Advantages of Dietary Therapy | 93 | ||
| Potential Limitations of Dietary Therapy | 94 | ||
| SUMMARY | 94 | ||
| REFERENCES | 95 | ||
| Endoscopic Treatment of Eosinophilic Esophagitis | 97 | ||
| Key points | 97 | ||
| INTRODUCTION | 97 | ||
| CLINICAL ASSESSMENT OF ESOPHAGEAL REMODELING | 98 | ||
| History | 98 | ||
| Barium Esophagram | 98 | ||
| Endoscopy | 99 | ||
| Other Tests: Manometry and Functional Luminal Imaging Probe Technology | 99 | ||
| Personal historical perspective on the role of esophageal dilation in eosinophilic esophagitis | 100 | ||
| General efficacy of esophageal dilation for eosinophilic esophagitis | 102 | ||
| Safety of esophageal dilation in patients with eosinophilic esophagitis | 102 | ||
| Guidelines for safe esophageal dilation | 104 | ||
| SPECIAL SITUATIONS | 105 | ||
| Pediatric Patients | 105 | ||
| Patients with Previous Postdilation Complications | 106 | ||
| Primary Therapy for Eosinophilic Esophagitis | 106 | ||
| SUMMARY | 107 | ||
| REFERENCES | 108 | ||
| Future Directions in Eosinophilic Esophagitis | 111 | ||
| Key points | 111 | ||
| DIAGNOSIS: BEYOND THE EOSINOPHIL | 112 | ||
| EPIDEMIOLOGY: BEYOND AN ORPHAN DISEASE | 114 | ||
| EVALUATION: BEYOND THE ESOPHAGEAL MUCOSA | 115 | ||
| TREATMENT ENDPOINTS: BEYOND COUNTING EOSINOPHILS | 116 | ||
| MEDICAL THERAPY: BEYOND TOPICAL CORTICOSTEROIDS | 117 | ||
| DIET THERAPY: BEYOND 6-FOOD ELIMINATION DIET PROTOCOL | 118 | ||
| SUMMARY | 119 | ||
| REFERENCES | 119 |