PMID- 31170743
OWN - NLM
STAT- MEDLINE
DCOM- 20190911
LR  - 20220408
IS  - 1439-7803 (Electronic)
IS  - 0044-2771 (Linking)
VI  - 57
IP  - 6
DP  - 2019 Jun
TI  - Clinical management of eosinophilic esophagitis - a nationwide survey among 
      gastroenterologists in Germany.
PG  - 745-752
LID - 10.1055/a-0885-1963 [doi]
AB  - BACKGROUND:  Eosinophilic esophagitis (EoE) is an increasingly recognized 
      immune-mediated esophageal disease and a common cause for dysphagia and food 
      bolus obstruction. The aim of this study was to evaluate the current clinical 
      management of EoE among adult gastroenterologists in Germany. METHODS:  We 
      performed a cross-sectional study of 1393 adult gastroenterologists using a 
      questionnaire containing 22 questions to general, diagnostic, and therapeutic 
      aspects of EoE. The self-administered online survey was conducted between 
      November 2017 and February 2018. Data capture and analysis was performed using 
      SurveyMonkey. RESULTS:  The overall responder rate was 29.6 %. More than half of 
      the responders (54.9 %) felt to observe a significant increase of EoE patients. 
      The EREFS score was mostly either unknown (44.3 %) or not routinely used 
      (52.2 %). If EoE was suspected, most responders obtained multiple esophageal 
      biopsies (n = 3 - 4: 35.7 %; n > 4: 61.6 %). The preferred primary treatment was 
      proton pump inhibitors (PPI) in 37.2 % and topical steroids in 35.0 % of 
      responders. PPI regimens were highly diverse, with only half of responders using 
      high-dose PPI regimens. Allergy testing was often initiated (always 25.4 %, 
      sometimes 48.9 %). The most common dietary therapy was 6-food elimination diet 
      (52 %), followed by allergy test-directed diets (16 %) and 2-food elimination 
      diet (16.5 %). The majority of responders indicated a need for long-term 
      treatment (i. e., 23 % of responders in > 50 % their patients and 47.7 % of 
      responders in 25 - 50 % of their patients). CONCLUSIONS:  Among 
      gastroenterologists in Germany, substantial variation in the adherence to 
      published EoE guidelines appears to exist. This indicates the need for 
      intensified education and national guidelines in order to optimize and harmonize 
      the clinical management of EoE patients.
CI  - (c) Georg Thieme Verlag KG Stuttgart . New York.
FAU - Miehlke, Stephan
AU  - Miehlke S
AD  - Center for Digestive Diseases, Internal Medicine Center Eppendorf, Hamburg.
AD  - Center for Esophageal Disorders, University Hospital Eppendorf, Hamburg.
FAU - von Arnim, Ulrike
AU  - von Arnim U
AD  - Dept. of Gastroenterology, Hepatology and Infectiology, University Hospital 
      Magdeburg.
FAU - Schlag, Christoph
AU  - Schlag C
AD  - II. Medical Dept, Klinikum Rechts der Isar, Technical University, Munich.
FAU - Frieling, Thomas
AU  - Frieling T
AD  - Medical Department II, Helios Hospital, Krefeld.
FAU - Madisch, Ahmed
AU  - Madisch A
AD  - Department of Internal Medicine, Siloah Hospital, Hannover.
FAU - Loibl, Rudolf
AU  - Loibl R
AD  - bng-Management, Ulm.
FAU - Mainz, Dagmar
AU  - Mainz D
AD  - Gastroenterologist in private practice, Saarlouis.
FAU - Labenz, Joachim
AU  - Labenz J
AD  - Internal Medicine, Jung-Stilling-Hospital, Siegen.
LA  - eng
PT  - Journal Article
TT  - Klinisches Management der eosinophilen Osophagitis - eine landesweite Umfrage 
      unter Gastroenterologen in Deutschland.
DEP - 20190606
PL  - Germany
TA  - Z Gastroenterol
JT  - Zeitschrift fur Gastroenterologie
JID - 0033370
RN  - 0 (Glucocorticoids)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adult
MH  - Cross-Sectional Studies
MH  - Diet Therapy/methods
MH  - Eosinophilic Esophagitis/diagnosis/*drug therapy
MH  - Gastroenterologists/*psychology
MH  - Gastroenterology
MH  - Germany
MH  - Glucocorticoids/therapeutic use
MH  - *Guideline Adherence
MH  - Humans
MH  - *Practice Guidelines as Topic
MH  - *Practice Patterns, Physicians'
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Surveys and Questionnaires
COIS- S. Miehlke has received speaker fees and consultant honoraria from Dr. Falk 
      Pharma/Falk Foundation, Celgene, Esocap, Aptalis, and Olympus. U. von Arnim, C. 
      Schlag, T. Frieling, A. Madisch, and J. Labenz received speaker fees from Dr. 
      Falk Pharma/Falk Foundation. D. Mainz and R. Loibl declared no conflicts of 
      interest.
EDAT- 2019/06/07 06:00
MHDA- 2019/09/12 06:00
CRDT- 2019/06/07 06:00
PHST- 2019/06/07 06:00 [entrez]
PHST- 2019/06/07 06:00 [pubmed]
PHST- 2019/09/12 06:00 [medline]
AID - 10.1055/a-0885-1963 [doi]
PST - ppublish
SO  - Z Gastroenterol. 2019 Jun;57(6):745-752. doi: 10.1055/a-0885-1963. Epub 2019 Jun 
      6.