Management of suspected and known eosinophilic esophagitis-anationwide survey in Austria.

Abstract

Eosinophilic esophagitis (EoE) is achronic immune-mediated disease of the esophagus with increasing incidence and dysphagia as the main symptom. The management of suspected or known EoE by Austrian endoscopists has not been investigated yet. Aweb-based survey with 13questions about the management of EoE was sent to endoscopists via the Austrian Society of Gastroenterology and Hepatology (ÖGGH). Atotal of 222 endoscopists (74% gastroenterologists, 23% surgeons, and 2% pediatricians; 68% working in ahospital) from all 9states participated. In patients with dysphagia but anormal appearing esophagus, 85% of respondents reported always taking biopsies; however, surgeons were less likely to obtain biopsies compared to gastroenterologists ("always" 69% vs. 90%, "sometimes" 29% vs. 10%, "never" 2% vs. 0%, p < 0.001). The approved budesonide orodispersible tablet is the preferred first-line drug used in EoE, ahead of proton pump inhibitors (PPI). Only 65% of participants monitor the patients by endoscopy and histology after 12weeks of induction therapy, 26% do not continue maintenance therapy, and 22% monitor patients only when symptomatic. The vast majority of Austrian endoscopists adhere to the European and US guidelines in cases of suspected EoE. In contrast, despite the chronic disease course, asignificant percentage of providers indicate not to use maintenance therapy and monitor the patients routinely.