Dr. Michael Chew @mchew85
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GrepMed Gastroenterology-Hepatology Editor, Academic Hospitalist UC Davis Medical Center Internal Medicine, Yale Gastroenterology Fellow '22
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Eosinophilic Esophagitis (EoE) - Spectrum of Response
Non-response:
 • Histology: Persistent eosinophilia, ≥ 15 eos/hpf
 • Symptoms:
Eosinophilic Esophagitis ... Histology: Persistent eosinophilia ... Histology: Reduced eosinophilia ... #Response #diagnosis ... #gastroenterology
Colonoscopy Followup Intervals 
10 years: Normal colonoscopy, ≥ 20 HP < 10mm
7-10 years: 1-2 adenomas <
Colonoscopy Followup ... years: Normal colonoscopy ... serrated polyps #Colonoscopy ... Followup #Intervals #gastroenterology ... #guidelines #management
Eosinophilic Gastroenteritis: Treatment Options Based on Severity of the Disease
Mild:
 • Trial of PPI
 • Trial
Eosinophilic Gastroenteritis ... • Additional diagnostic ... as CT scan #EoE ... Gastroenteritis #Treatment #management ... #gastroenterology
Eosinophilic Esophagitis (EoE) - Endoscopic ReFerence Score (EREFS)
Edema (Loss of vascular markings):
 - Grade 0: Distinct
Eosinophilic Esophagitis ... (EoE) - Endoscopic ... #Eosinophilic # ... ReFerence #Score #diagnosis ... classification #gastroenterology
Refractory Eosinophilic Esophagitis (EOE) Management Algorithm
Initial treatment with topical steroids
Initial treatment with dietary elimination
Continued EoE nonresponse:
Refractory Eosinophilic ... ) Management Algorithm ... #Eosinophilic # ... Esophagitis #Management ... #Algorithm #gastroenterology
Endoscopic Bleeding Risk - Summary points from ASGE guideline 

Low Risk Procedures 
 - Diagnostic endoscopy
points from ASGE guideline ... Procedures - Diagnostic ... Bleeding #Risks #Gastroenterology ... LowRisk #HighRisk #Diagnosis ... #Management #Guidelines
Secondary Causes of Esophageal Eosinophilia (EoE) - Differential Diagnosis
 • Gastroesophageal reflux disease
 • Eosinophilic gastrointestinal
(EoE) - Differential ... Diagnosis • Gastroesophageal ... wasting syndrome #Eoe ... #Differential #Diagnosis ... Secondary #Causes #gastroenterology
Eosinophilic Esophagitis (EoE) - Treatment Algorithm
Medical therapy:
 • Proton pump inhibition
 • Topical corticosteroids
Diet therapy
 •
Eosinophilic Esophagitis ... (EoE) - Treatment ... #Eosinophilic # ... Treatment #Algorithm #management ... #gastroenterology
Eosinophilic Gastroenteritis Management Algorithm
 - PPI x 8 weeks
 - Dietary therapy with Empiric Elimination or
Eosinophilic Gastroenteritis ... Management Algorithm ... x 4-8 wks #EoE ... #Eosinophilic # ... Algorithm #Treatment #gastroenterology
Eosinophilic Esophagitis (EoE) - Topical Corticosteroids
 • Liquid - Budesonide - 1 mg PO BID -
Eosinophilic Esophagitis ... (EoE) - Topical ... is available Gastroenterology ... @GIreview #Eosinophilic ... Corticosteroids #management