PMID- 29092029
OWN - NLM
STAT- MEDLINE
DCOM- 20180904
LR  - 20180904
IS  - 1442-2050 (Electronic)
IS  - 1120-8694 (Linking)
VI  - 31
IP  - 2
DP  - 2018 Feb 1
TI  - Management of eosinophilic esophagitis in daily clinical practice.
LID - 10.1093/dote/dox119 [doi]
AB  - In recent years, new guidelines and recommendations have been published regarding 
      the diagnostic criteria and therapeutic management of eosinophilic esophagitis 
      (EoE). The aim of this study is to assess the diagnostic and therapeutic 
      management of patients diagnosed with EoE in daily clinical practice and whether 
      this was performed according to current guidelines and recommendations. A 
      population-based, multicenter retrospective cohort study was conducted using data 
      from the national pathology registry (PALGA), medical records, and telephone 
      interviews of patients diagnosed with EoE in two academic and two nonacademic 
      hospitals in the period 2004 to 2014. The study was approved by all involved 
      ethical committees. Data regarding demographics, clinical manifestations, 
      endoscopic results, histologic samples, and therapeutic strategies were 
      collected. Standard statistical analyses were performed to summarize patient 
      characteristics. We included 119 patients diagnosed with EoE in this study. The 
      median age at onset of symptoms was 29 years (IQR: 15-42) and the median age at 
      diagnosis was 38 years (IQR: 23-51 years), leading to a median diagnostic 
      patients' delay of 6.5 years (IQR: 2-14 years). The median physicians' delay in 
      diagnosis between first contact in the hospital and diagnosis was 1.0 year (IQR: 
      1-7 years). The incidence of newly diagnosed patients with EoE increased steadily 
      over a period of 11 years. Criteria for the microscopic diagnosis of EoE varied 
      between pathologists in each hospital. Initial treatment included topical 
      corticosteroids (TCS) (30.3%), proton pump inhibitors (PPI) (29.4%), or a 
      combination (10.1%). A follow-up endoscopy was performed in 40.3% of patients. 
      During follow-up, treatment included PPIs (76.0%), TCS (59.6%), a combination of 
      PPIs and TCS (45.4%), and endoscopic dilations (6.7%). Diagnostic and therapeutic 
      discrepancies between daily clinical practice and recommendations from current 
      and past guidelines were observed. Apart from developing guidelines, efforts 
      should be undertaken to implement these in daily clinical practice.
FAU - Vermeulen, B D
AU  - Vermeulen BD
AD  - Department of Gastroenterology and Hepatology, Radboud University Medical Center, 
      Nijmegen.
AD  - Department of Gastroenterology and Hepatology, University Medical Center Utrecht, 
      Utrecht.
FAU - Bogte, A
AU  - Bogte A
AD  - Department of Gastroenterology and Hepatology, University Medical Center Utrecht, 
      Utrecht.
FAU - Verhagen, M A
AU  - Verhagen MA
AD  - Department of Gastroenterology and Hepatology, Diakonessenhuis, Utrecht/Zeist.
FAU - Pullens, H J M
AU  - Pullens HJM
AD  - Department of Gastroenterology and Hepatology, Meander Medical Center, 
      Amersfoort, the Netherlands.
FAU - Siersema, P D
AU  - Siersema PD
AD  - Department of Gastroenterology and Hepatology, Radboud University Medical Center, 
      Nijmegen.
AD  - Department of Gastroenterology and Hepatology, University Medical Center Utrecht, 
      Utrecht.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Dis Esophagus
JT  - Diseases of the esophagus : official journal of the International Society for 
      Diseases of the Esophagus
JID - 8809160
RN  - 0 (Glucocorticoids)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Cohort Studies
MH  - *Deglutition Disorders/diagnosis/etiology/prevention & control
MH  - *Delayed Diagnosis/prevention & control/statistics & numerical data
MH  - Endoscopy/methods
MH  - *Eosinophilic Esophagitis/complications/diagnosis/epidemiology/therapy
MH  - Esophagus/*pathology
MH  - Female
MH  - Glucocorticoids/therapeutic use
MH  - Humans
MH  - Interviews as Topic
MH  - Male
MH  - Medical Records/statistics & numerical data
MH  - Middle Aged
MH  - Needs Assessment
MH  - Netherlands/epidemiology
MH  - *Patient Care Management/methods/statistics & numerical data
MH  - Proton Pump Inhibitors/therapeutic use
MH  - Registries/statistics & numerical data
EDAT- 2017/11/02 06:00
MHDA- 2018/09/05 06:00
CRDT- 2017/11/02 06:00
PHST- 2017/06/02 00:00 [received]
PHST- 2017/09/03 00:00 [accepted]
PHST- 2017/11/02 06:00 [pubmed]
PHST- 2018/09/05 06:00 [medline]
PHST- 2017/11/02 06:00 [entrez]
AID - 4582625 [pii]
AID - 10.1093/dote/dox119 [doi]
PST - ppublish
SO  - Dis Esophagus. 2018 Feb 1;31(2). doi: 10.1093/dote/dox119.