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Eosinophilic Esophagitis

Works Count: 42972

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Description

This cluster of papers focuses on the diagnosis and management of eosinophilic esophagitis in both children and adults. It covers various aspects including treatment guidelines, epidemiology, histologic remission, and the use of food elimination diets. The research provides updated consensus recommendations, evidence-based approaches, and insights into the natural history and etiological factors of eosinophilic esophagitis.

Keywords

Eosinophilic Esophagitis; Diagnosis; Management; Children; Adults; Treatment; Guidelines; Epidemiology; Histologic Remission; Food Elimination Diet

Barrett's esophagus

1987-01-01

Charles Winters , Timothy J. Spurling , Sarkis J. Chobanian +7 more

Columnar-lined lower esophagus: An acquired lesion with malignant predisposition

1975-11-01

A P Naef , M Savary , Luciano Ozzello +1 more

Histological Consequences of Gastroesophageal Reflux in Man

1970-02-01

Farhad Ismail-Beigi , Paul F. Horton , Charles E. Pope

A Randomized, Double-Blind, Placebo-Controlled Trial of Fluticasone Propionate for Pediatric Eosinophilic Esophagitis

2006-08-17

Michael R. Konikoff , Richard J. Noel , Carine Blanchard +7 more

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Eosinophilic gastrointestinal disorders (EGID)☆

2004-01-01

Marc E. Rothenberg

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Budesonide Is Effective in Adolescent and Adult Patients With Active Eosinophilic Esophagitis

2010-08-03

Alex Straumann , Sébastien Conus , Lukas Degen +7 more

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14 Years of Eosinophilic Esophagitis: Clinical Features and Prognosis

2009-01-01

Jonathan M. Spergel , Terri F Brown‐Whitehorn , Janet L. Beausoleil +4 more

To determine the natural history of treated and untreated eosinophilic esophagitis (EE) and examine the presenting symptoms of EE.Retrospective and prospective chart review of all patients diagnosed with EE at … To determine the natural history of treated and untreated eosinophilic esophagitis (EE) and examine the presenting symptoms of EE.Retrospective and prospective chart review of all patients diagnosed with EE at The Children's Hospital of Philadelphia. EE was defined as greater than 20 eosinophils per high power field after treatment with reflux medications.We identified 620 patients in our database in the last 14 years and 330 patients with greater than 1 year of follow-up for analysis. The number of new EE patients has increased on an annual basis. Of the patients presenting with EE, 68% were younger than 6 years old. Reflux symptoms and feeding issues/failure to thrive were the most common presenting symptoms for EE. Eleven patients had resolution of all of their food allergies and 33 patients had resolutions of some of their food allergies. No patients have progression of EE into other gastrointestinal disorders.EE is a chronic disease with less than 10% of the population developing tolerance to their food allergies. EE does not progress into other gastrointestinal diseases.

European evidence based consensus for endoscopy in inflammatory bowel disease

2013-11-01

Vito Annese , Marco Daperno , Matthew D. Rutter +7 more

Endoscopy plays an essential role in the diagnosis, management, prognosis, and surveillance of inflammatory bowel disease (IBD), but surprisingly there are few available guidelines.1,2 This prompted the ECCO Guidelines Committee … Endoscopy plays an essential role in the diagnosis, management, prognosis, and surveillance of inflammatory bowel disease (IBD), but surprisingly there are few available guidelines.1,2 This prompted the ECCO Guidelines Committee (GuiCom) members to promote a Consensus on the appropriate indication and application of different endoscopic modalities in IBD. Since the development of guidelines is an expensive and time-consuming process, this Consensus may help to avoid duplication of effort in the future. It may also identify issues where the evidence is lacking and controlled studies are awaited. The strategy to reach the Consensus involved five steps: 1. Two members of the GuiCom (VA and RE) identified four main topics: a) Diagnosis and follow-up; b) Score of endoscopic activity; c) Small bowel endoscopy; and d) Surveillance. During 2012 a call for participants to the Guideline was made to ECCO members. In addition, expert endoscopists recognised for their active research in the field were invited. Participants were selected by the Guicom and four working groups were created. Each working group had a chair (VA, MD, MT, and RE), two ECCO members including young members (Y-ECCO) and one experienced endoscopist. For the development of the guideline, relevant questions on separate topics were devised by the chairmen and their working parties. The questions were focused on current practice and areas of controversy. Participants of the Consensus process were asked to answer the questions based on evidence from the literature as well as their experience (Delphi procedure)3; 2. The working parties working in parallel performed a systematic literature search of their topic with the appropriate key words using Medline/Pubmed and the Cochrane database, as well as other relevant sources; 3. Provisional guideline statements on their topic were then written by the chairmen. These were circulated and commented on first by working party members and …

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ASSOCIATIONS BETWEEN ANKYLOSING SPONDYLITIS, PSORIATIC ARTHRITIS, REITERʼS DISEASE, THE INTESTINAL ARTHROPATHIES, AND BEHCETʼS SYNDROME

1974-09-01

J. M. H. Moll , I Haslock , I F Macrae +1 more

MOLL, J M H B.Sc.,D.M., M.R.C.P.,; HASLOCK, IAN M.D.; MACRAE, I F M. B., B.S; WRIGHT, V M.D., F.R.C.P. Author Information MOLL, J M H B.Sc.,D.M., M.R.C.P.,; HASLOCK, IAN M.D.; MACRAE, I F M. B., B.S; WRIGHT, V M.D., F.R.C.P. Author Information

Barrett's Esophagus

2002-03-14

Stuart J. Spechler

A 55-year-old man has had frequent heartburn for more than 10 years. Endoscopy reveals columnar epithelium lining the distal 5 cm of the esophagus. Biopsy specimens show specialized intestinal metaplasia … A 55-year-old man has had frequent heartburn for more than 10 years. Endoscopy reveals columnar epithelium lining the distal 5 cm of the esophagus. Biopsy specimens show specialized intestinal metaplasia with inflammation and possible dysplasia. How should this patient's condition be managed?

Eosinophilic esophagitis: Updated consensus recommendations for children and adults

2011-04-09

Chris A. Liacouras , Glenn T. Furuta , Ikuo Hirano +7 more

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Human eotaxin is a specific chemoattractant for eosinophil cells and provides a new mechanism to explain tissue eosinophilia

1996-04-01

Eduardo A. García‐Zepeda , Marc E. Rothenberg , Robert T. Ownbey +3 more

An etiological role for aeroallergens and eosinophils in experimental esophagitis

2001-01-01

Anil Mishra , Simon P. Hogan , Eric B. Brandt +1 more

Eosinophil infiltration into the esophagus is observed in diverse diseases including gastroesophageal reflux and allergic gastroenteritis, but the processes involved are largely unknown. We now report an original model of … Eosinophil infiltration into the esophagus is observed in diverse diseases including gastroesophageal reflux and allergic gastroenteritis, but the processes involved are largely unknown. We now report an original model of experimental esophagitis induced by exposure of mice to respiratory allergen. Allergen-challenged mice develop marked levels of esophageal eosinophils, free eosinophil granules, and epithelial cell hyperplasia, features that mimic the human disorders. Interestingly, exposure of mice to oral or intragastric allergen does not promote eosinophilic esophagitis, indicating that hypersensitivity in the esophagus occurs with simultaneous development of pulmonary inflammation. Furthermore, in the absence of eotaxin, eosinophil recruitment is attenuated, whereas in the absence of IL-5, eosinophil accumulation and epithelial hyperplasia are ablated. These results establish a pathophysiological connection between allergic hypersensitivity responses in the lung and esophagus and demonstrate an etiologic role for inhaled allergens and eosinophils in gastrointestinal inflammation.

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Chronic peptic ulcerz of the œophagus and ‘œsophagitis’

1950-10-01

N R Barrett

Journal Article Chronic peptic ulcerz of the œophagus and 'œsophagitis' Get access N R Barrett N R Barrett London Search for other works by this author on: Oxford Academic Google … Journal Article Chronic peptic ulcerz of the œophagus and 'œsophagitis' Get access N R Barrett N R Barrett London Search for other works by this author on: Oxford Academic Google Scholar British Journal of Surgery, Volume 38, Issue 150, October 1950, Pages 175–182, https://doi.org/10.1002/bjs.18003815005 Published: 06 December 2005

Eosinophilic esophagitis attributed to gastroesophageal reflux: Improvement with an amino acid-based formula

1995-11-01

Kevin J. Kelly , Audrey J. Lazenby , Peter C. Rowe +3 more

Elemental diet is an effective treatment for eosinophilic esophagitis in children and adolescents

2003-04-01

Jonathan E. Markowitz , Jonathan M. Spergel , Eduardo D. Ruchelli +1 more

Eosinophilic esophagitis (EoE), a disorder characterized by eosinophilic infiltration of the esophageal mucosa, has been defined in large part through published case reports and series leading to ambiguity in both … Eosinophilic esophagitis (EoE), a disorder characterized by eosinophilic infiltration of the esophageal mucosa, has been defined in large part through published case reports and series leading to ambiguity in both diagnostic and treatment options. Corticosteroids, cromolyn, and elemental diet have all been reported as successful treatments for EoE. In this study, we sought to accurately define a population of patients with EoE and then assess their response to elemental diet.A series of patients with chronic symptoms of gastroesophageal reflux disease and an isolated esophageal eosinophilia on esophagogastroduodenoscopy (EGD) were identified. Therapy with a proton pump inhibitor was instituted for 3 months, followed by repeat EGD when symptoms persisted. A 24-h pH probe study was performed, and those with significantly abnormal studies were excluded. The remaining patients were diagnosed with EoE and placed on an elemental diet for 1 month, followed by a repeat EGD.Of 346 patients with chronic gastroesophageal reflux disease symptoms and eosinophils on esophageal biopsy, 51 (14.7%) were ultimately diagnosed with EoE. There was significant improvement in vomiting, abdominal pain, and dysphagia after the elemental diet. The median number of esophageal eosinophils per high-powered field (HPF) decreased from 33.7 before the diet to 1.0 after the diet (p <0.01). The average time to clinical improvement was 8.5 days.Elemental diet resulted in striking improvement in both symptoms and histologic evidence of disease in children and adolescents with EoE, as identified by strict diagnostic criteria.

Eosinophilic Esophagitis in Children and Adults: A Systematic Review and Consensus Recommendations for Diagnosis and Treatment

2007-08-09

Glenn T. Furuta , Chris A. Liacouras , Margaret H. Collins +7 more

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Histopathologic variability and endoscopic correlates in adults with eosinophilic esophagitis

2006-09-01

Nirmala Gonsalves , Maria Luisa Policarpio‐Nicolas , Qing Zhang +2 more

Epidemiology of Eosinophilic Esophagitis Over Three Decades in Olmsted County, Minnesota

2009-07-02

Ganapathy A. Prasad , J Alexander , Cathy D. Schleck +5 more

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IL-25 Induces IL-4, IL-5, and IL-13 and Th2-Associated Pathologies In Vivo

2001-12-01

Madeline Fort , Jeanne Cheung , David Yen +7 more

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Nonsteroidal Anti-inflammatory Drug Use and Increased Risk for Peptic Ulcer Disease in Elderly Persons

1991-02-15

Marie R. Griffin , Joyce M. Piper , James R. Daugherty +2 more

Objective: To evaluate the relative risk for peptic ulcer disease that is associated with the use of nonaspirin nonsteroidal anti-inflammatorydrugs. Design: Nested case-control study. Setting: Tennessee Medicaid program. Participants: Medicaid … Objective: To evaluate the relative risk for peptic ulcer disease that is associated with the use of nonaspirin nonsteroidal anti-inflammatorydrugs. Design: Nested case-control study. Setting: Tennessee Medicaid program. Participants: Medicaid enrollees 65 years of age or older were included in the study. The 1415 case patients had been hospitalized for confirmed peptic ulcer disease at some point from 1984 through 1986. The 7063 control persons represented a stratified random sample of other Medicaid enrollees. Measurements and Main Results: The estimated relative risk for the development of peptic ulcer disease among current users of nonaspirin nonsteroidal anti-inflammatory drugs, compared with that among nonusers, was 4.1 (95% CI, 3.5 to 4.7). For current users, the risk increased with increasing dose, from a relative risk of 2.8 (CI, 1.8 to 4.3) for the lowest to a relative risk of 8.0 (CI, 4.4 to 14.8) for the highest dose category. The risk was greatest in the first month of use (relative risk, 7.2; CI, 4.9 to 10.5). If the association is fully causal, 29% of peptic ulcers in the study sample resulted from the use of these drugs, and the excess risk associated with such use was 17.4 hospitalizations for ulcer disease per 1000 person-years of exposure. Conclusions: These data support other findings indicating that a clinically significant risk for serious ulcer disease is associated with the use of nonaspirin nonsteroidal anti-inflammatory drugs. The data show that this risk increases with dose and recency of use and that use of these drugs may be responsible for a large proportion of peptic ulcer disease among elderly persons.

Eosinophilic gastroenteritis: a clinicopathological study of patients with disease of the mucosa, muscle layer, and subserosal tissues.

1990-01-01

Nicholas J. Talley , R. G. Shorter , S.F. Phillips +1 more

The aim of this study was to evaluate the clinicopathological spectrum of eosinophilic gastroenteritis and identify possible difficulties in establishing the diagnosis. All patients with a diagnosis of eosinophilic gastroenteritis, … The aim of this study was to evaluate the clinicopathological spectrum of eosinophilic gastroenteritis and identify possible difficulties in establishing the diagnosis. All patients with a diagnosis of eosinophilic gastroenteritis, defined by the presence of gastrointestinal symptoms and eosinophilic infiltration of the gut (38), or a radiological diagnosis with peripheral eosinophilia (two), were identified from the Mayo Clinic records; in none was there evidence of extraintestinal disease. Patients were divided into three groups according to the Klein classification: predominant mucosal (23), muscular (12), or subserosal disease (five). A fourth group of patients (10) for comparison had abdominal symptoms and unexplained peripheral eosinophilia but no proven eosinophilic infiltration of the gut. It was found that a history of allergy was reported by 20 of 40 patients with eosinophilic gastroenteritis. Peripheral eosinophilia was absent in nine of 40. The patients with subserosal disease were distinct from the other groups in presentation (abdominal bloating, ascites), higher eosinophil counts and in their dramatic responses to steroid therapy. Otherwise the patients were similar regarding demographic factors, presenting symptoms (abdominal pain, nausea, weight loss, diarrhoea), and laboratory parameters. The ESR was moderately raised in 10 of 40 patients. The disease may affect any area of the gastrointestinal tract; eosinophilic infiltration was documented in the oesophagus in one patient and in the colon in two cases. Endoscopic biopsies missed the diagnosis in five of 40 presumably because of patchy disease. Eosinophilic gastroenteritis should be considered in the differential diagnosis of unexplained gastrointestinal symptoms even in the absence of peripheral eosinophilia.

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The use of skin prick tests and patch tests to identify causative foods in eosinophilic esophagitis

2002-02-01

Jonathan M. Spergel , Janet L. Beausoleil , Maria R. Mascarenhas +1 more

Efficacy of Dietary Interventions for Inducing Histologic Remission in Patients With Eosinophilic Esophagitis: A Systematic Review and Meta-analysis

2014-02-15

Ángel Arias , Jesús González‐Cervera , José María Tenías +1 more

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WEGENERʼS GRANULOMATOSIS: STUDIES IN EIGHTEEN PATIENTS AND A REVIEW OF THE LITERATURE

1973-11-01

Anthony S. Fauci , Sheldon Wolff

From the Laboratory of Clinical Investigation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20014 From the Laboratory of Clinical Investigation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20014

Esophageal eosinophilia with dysphagia

1993-01-01

Stephen E. Attwood , Thomas C. Smyrk , Tom R. DeMeester +1 more

Natural history of primary eosinophilic esophagitis: a follow-up of 30 adult patients for up to 11.5 years

2003-12-01

Alex Straumann , Hanspeter Spichtin , Leticia Grize +3 more

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Caesarean delivery and risk of atopy and allergic disesase: meta‐analyses

2008-02-11

Peter Bager , Jan Wohlfahrt , Tine Westergaard

Summary Background Studies of delivery by caesarean section (c‐section) and the offspring's risk of allergic diseases are of current interest due to concerns about the increased use of c‐section in … Summary Background Studies of delivery by caesarean section (c‐section) and the offspring's risk of allergic diseases are of current interest due to concerns about the increased use of c‐section in many countries. However, previous studies have reported inconsistent findings. Objective We investigated whether delivery by c‐section is associated with an increased risk of atopy and allergic disease by reviewing the literature, performing a meta‐analysis, and assessing publication bias. Methods We used a systematic literature search of MEDLINE (1966 to May 2007). Six common allergic outcomes were included: food allergy/food atopy, inhalant atopy, eczema/atopic dermatitis, allergic rhinitis, asthma, and hospitalization for asthma. For each outcome a meta‐analysis was performed, where a summary odds ratio (OR) was calculated taking into account heterogeneity between the study‐specific relative risks. Publication bias was assessed using the funnel plot method. Results We identified 26 studies on delivery by c‐section and one or more of the six allergic outcomes. C‐section was associated with an increased summary OR of food allergy/food atopy (OR 1.32, 95% CI 1.12–1.55; six studies), allergic rhinitis (OR 1.23, 95% CI 1.12–1.35; seven studies), asthma (OR 1.18, 95% CI 1.05–1.32; 13 studies), and hospitalization for asthma (OR 1.21, 95% CI 1.12–1.31; seven studies), whereas there was no association with inhalant atopy (OR 1.06, 95% CI 0.82–1.38; four studies) and eczema/atopic dermatitis (OR 1.03, 95% CI 0.98–1.09; six studies). Funnel plots indicated that the association with food allergy/food atopy could be difficult to interpret due to publication bias. For each significant association with an allergic outcome, only 1–4% of cases were attributable to c‐section. Conclusion Delivery by c‐section is associated with a moderate risk increase for allergic rhinitis, asthma, hospitalization for asthma, and perhaps food allergy/food atopy, but not with inhalant atopy or atopic dermatitis. The increased use of c‐section during the last decades is unlikely to have contributed much to the allergy epidemic observed during the same period.

Reslizumab in children and adolescents with eosinophilic esophagitis: Results of a double-blind, randomized, placebo-controlled trial

2011-12-30

Jonathan M. Spergel , Marc E. Rothenberg , Margaret H. Collins +7 more

Eosinophils: Biological Properties and Role in Health and Disease

2008-04-01

Simon P. Hogan , Helene F. Rosenberg , Redwan Moqbel +5 more

SUMMARY Eosinophils are pleiotropic multifunctional leukocytes involved in initiation and propagation of diverse inflammatory responses, as well as modulators of innate and adaptive immunity. In this review, the biology of … SUMMARY Eosinophils are pleiotropic multifunctional leukocytes involved in initiation and propagation of diverse inflammatory responses, as well as modulators of innate and adaptive immunity. In this review, the biology of eosinophils is summarized, focusing on transcriptional regulation of eosinophil differentiation, characterization of the growing properties of eosinophil granule proteins, surface proteins and pleiotropic mediators, and molecular mechanisms of eosinophil degranulation. New views on the role of eosinophils in homeostatic function are examined, including developmental biology and innate and adaptive immunity (as well as their interaction with mast cells and T cells) and their proposed role in disease processes including infections, asthma, and gastrointestinal disorders. Finally, strategies for targeted therapeutic intervention in eosinophil‐mediated mucosal diseases are conceptualized.

Anti-interleukin-5 antibody treatment (mepolizumab) in active eosinophilic oesophagitis: a randomised, placebo-controlled, double-blind trial

2009-10-13

Alex Straumann , Sébastien Conus , Pascale Grzonka +7 more

<h3>Objective:</h3> Eosinophilic oesophagitis (EoO) is a clinicopathological condition defined by proton pump inhibitor-refractory oesophageal symptoms combined with oesophageal eosinophilia. The pharmacodynamic effect of mepolizumab (a humanised anti-interleukin-5 monoclonal antibody) in … <h3>Objective:</h3> Eosinophilic oesophagitis (EoO) is a clinicopathological condition defined by proton pump inhibitor-refractory oesophageal symptoms combined with oesophageal eosinophilia. The pharmacodynamic effect of mepolizumab (a humanised anti-interleukin-5 monoclonal antibody) in EoO was evaluated. <h3>Methods:</h3> Eleven adults with active EoO (>20 peak eosinophil number/high power field (hpf) and dysphagia) were randomised to 750 mg of mepolizumab (n = 5) or placebo (n = 6) and received two intravenous infusions, 1 week apart. Those not in complete remission (<5 peak eosinophil number/hpf) after 8 weeks received two further doses 4 weeks apart, 1500 mg of mepolizumab or placebo. The effect of mepolizumab was assessed clinically, endoscopically, histologically, and via blood and tissue biomarkers. <h3>Results:</h3> As assessed by immunofluorescence, a marked reduction of mean oesophageal eosinophilia (p = 0.03) was seen in the mepolizumab group (−54%) compared with the placebo group (−5%) 4 weeks after initiation of treatment. No further reduction of eosinophil numbers was observed in response to the two additional infusions in either group. Mepolizumab reduced tenascin C (p = 0.033) and transforming growth factor β1 (p = 0.05) expression in the oesophageal epithelial layer 13 weeks after initiation of treatment. Clinically, limited improvement of symptoms was seen, although a trend was seen between 4 and 13 weeks after initiation of mepolizumab treatment. Mepolizumab was well tolerated. <h3>Conclusions:</h3> Mepolizumab significantly reduced eosinophil numbers in oesophageal tissues in adult patients with active EoO, and changes in the expression of molecules associated with oesophageal remodelling were reversed. Minimal clinical improvement was achieved in a subgroup of patients with EoO. Mepolizumab had an acceptable safety profile, even at the high 1500 mg dose level. <h3>Trial registration number:</h3> NCT00274703

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ACG Clinical Guideline: Evidenced Based Approach to the Diagnosis and Management of Esophageal Eosinophilia and Eosinophilic Esophagitis (EoE)

2013-04-09

Evan S. Dellon , Nirmala Gonsalves , Ikuo Hirano +3 more

Esophageal eosinophilia and eosinophilic esophagitis (EoE) are increasingly recognized and prevalent conditions, which now represent common clinical problems encountered by gastroenterologists, pathologists, and allergists. The study of EoE has become … Esophageal eosinophilia and eosinophilic esophagitis (EoE) are increasingly recognized and prevalent conditions, which now represent common clinical problems encountered by gastroenterologists, pathologists, and allergists. The study of EoE has become a dynamic field with an evolving understanding of the pathogenesis, diagnosis, and treatment. Although there are limited data supporting management decisions, clinical parameters are needed to guide the care of patients with eosinophilic-esophageal disorders. In this evidence-based review, recommendations developed by adult and pediatric gastroenterologists are provided for the evaluation and management of these patients. New terminology is emphasized, particularly the concepts of esophageal eosinophilia and proton-pump inhibitor-responsive esophageal eosinophilia (PPI-REE) as entities distinct from EoE.

Eosinophilic Esophagitis: A 10-Year Experience in 381 Children

2005-12-01

Chris A. Liacouras , Jonathan M. Spergel , Eduardo D. Ruchelli +7 more

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Effect of Six-Food Elimination Diet on Clinical and Histologic Outcomes in Eosinophilic Esophagitis

2006-07-22

Amir F. Kagalwalla , Timothy Sentongo , Sally Ritz +5 more

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Idiopathic eosinophilic esophagitis is associated with a TH2-type allergic inflammatory response

2001-12-01

Alex Straumann , Madeleine Bauer , Barbra Fischer +2 more

Elimination Diet Effectively Treats Eosinophilic Esophagitis in Adults; Food Reintroduction Identifies Causative Factors

2012-03-06

Nirmala Gonsalves , Guang‐Yu Yang , Bethany Doerfler +3 more

Treatment of eosinophilic esophagitis with specific food elimination diet directed by a combination of skin prick and patch tests

2005-10-01

Jonathan M. Spergel , Timothy Andrews , Terri F. Brown‐Whitehorn +2 more

Eotaxin-3 and a uniquely conserved gene-expression profile in eosinophilic esophagitis

2006-01-19

Carine Blanchard

Eosinophilic esophagitis (EE) is an emerging disorder with a poorly understood pathogenesis. In order to define disease mechanisms, we took an empirical approach analyzing esophageal tissue by a genome-wide microarray … Eosinophilic esophagitis (EE) is an emerging disorder with a poorly understood pathogenesis. In order to define disease mechanisms, we took an empirical approach analyzing esophageal tissue by a genome-wide microarray expression analysis. EE patients had a striking transcript signature involving 1% of the human genome that was remarkably conserved across sex, age, and allergic status and was distinct from that associated with non-EE chronic esophagitis. Notably, the gene encoding the eosinophil-specific chemoattractant eotaxin-3 (also known as CCL26) was the most highly induced gene in EE patients compared with its expression level in healthy individuals. Esophageal eotaxin-3 mRNA and protein levels strongly correlated with tissue eosinophilia and mastocytosis. Furthermore, a single-nucleotide polymorphism in the human eotaxin-3 gene was associated with disease susceptibility. Finally, mice deficient in the eotaxin receptor (also known as CCR3) were protected from experimental EE. These results implicate eotaxin-3 as a critical effector molecule for EE and provide insight into disease pathogenesis.

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Delay in Diagnosis of Eosinophilic Esophagitis Increases Risk for Stricture Formation in a Time-Dependent Manner

2013-08-13

Alain Schoepfer , Ekaterina Safroneeva , Christian Bussmann +4 more

Endoscopic assessment of the oesophageal features of eosinophilic oesophagitis: validation of a novel classification and grading system

2012-05-22

Ikuo Hirano , Nelson Moy , Michael G. Heckman +3 more

<h3>Abstract</h3> Brain-machine interfaces (BMIs) hold promise for the restoration of sensory and motor function and the treatment of neurological disorders, but clinical BMIs have not yet been widely adopted, in … <h3>Abstract</h3> Brain-machine interfaces (BMIs) hold promise for the restoration of sensory and motor function and the treatment of neurological disorders, but clinical BMIs have not yet been widely adopted, in part because modest channel counts have limited their potential. In this white paper, we describe Neuralink's first steps toward a scalable high-bandwidth BMI system. We have built arrays of small and flexible electrode "threads", with as many as 3,072 electrodes per array distributed across 96 threads. We have also built a neurosurgical robot capable of inserting six threads (192 electrodes) per minute. Each thread can be individually inserted into the brain with micron precision for avoidance of surface vasculature and targeting specific brain regions. The electrode array is packaged into a small implantable device that contains custom chips for low-power on-board amplification and digitization: the package for 3,072 channels occupies less than (23 × 18.5 × 2) mm<sup>3</sup>. A single USB-C cable provides full-bandwidth data streaming from the device, recording from all channels simultaneously. This system has achieved a spiking yield of up to 85.5 % in chronically implanted electrodes. Neuralink's approach to BMI has unprecedented packaging density and scalability in a clinically relevant package.

Primary Eosinophilic Esophagitis in Children: Successful Treatment with Oral Corticosteroids

1998-04-01

Chris A. Liacouras , William J. Wenner , Kurt Brown +1 more

The histologic appearance of esophageal eosinophils has been correlated with esophagitis and gastroesophageal reflux disease in children. Esophageal eosinophilia that persists despite traditional antireflux therapy may not represent treatment failure, … The histologic appearance of esophageal eosinophils has been correlated with esophagitis and gastroesophageal reflux disease in children. Esophageal eosinophilia that persists despite traditional antireflux therapy may not represent treatment failure, but instead may portray early eosinophilic gastroenteritis or allergic esophagitis. In this study, a series of pediatric patients with severe esophageal eosinophilia who were unresponsive to aggressive antireflux therapy were examined and their clinical and histologic response to oral corticosteroid therapy assessed.Of 1809 patients evaluated prospectively over 2.5 years for symptoms of gastroesophageal reflux, 20 had persistent symptoms and esophageal eosinophilia, despite aggressive therapy with omeprazole and cisapride. These patients were treated with 1.5 mg/kg oral methylprednisolone per day, divided into twice-daily doses for 4 weeks. All patients underwent clinical, laboratory, and histologic evaluation before and after treatment.Histologic findings in examination of specimens obtained in pretreatment esophageal biopsies in children with primary eosinophilic esophagitis indicated significantly greater eosinophilia (34.2+/-9.6 eosinophils/high-power field [HPF]) compared with that in children with gastroesophageal reflux disease who responded to medical therapy (2.26+/-1.16 eosinophils/HPF; p < 0.001). After corticosteroid therapy, all but one patient with primary eosinophilic esophagitis had dramatic clinical improvement, supported by histologic examination (1.5 +/-0.9 eosinophils/HPF, p < 0.0001).Pediatric patients in a series with marked esophageal eosinophilia and chronic symptoms of gastroesophageal reflux disease unresponsive to aggressive medical antire-flux therapy had both clinical and histologic improvement after oral corticosteroid therapy.

Guidelines on eosinophilic esophagitis: evidence‐based statements and recommendations for diagnosis and management in children and adults

2017-01-24

Alfredo J. Lucendo , Javier Molina‐Infante , Ángel Arias +7 more

Eosinophilic esophagitis (EoE) is one of the most prevalent esophageal diseases and the leading cause of dysphagia and food impaction in children and young adults. This underlines the importance of … Eosinophilic esophagitis (EoE) is one of the most prevalent esophageal diseases and the leading cause of dysphagia and food impaction in children and young adults. This underlines the importance of optimizing diagnosys and treatment of the condition, especially after the increasing amount of knowledge on EoE recently published. Therefore, the UEG, EAACI ESPGHAN, and EUREOS deemed it necessary to update the current guidelines regarding conceptual and epidemiological aspects, diagnosis, and treatment of EoE.General methodology according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used in order to comply with current standards of evidence assessment in formulation of recommendations. An extensive literature search was conducted up to August 2015 and periodically updated. The working group consisted of gastroenterologists, allergists, pediatricians, otolaryngologists, pathologists, and epidemiologists. Systematic evidence-based reviews were performed based upon relevant clinical questions with respect to patient-important outcomes.The guidelines include updated concept of EoE, evaluated information on disease epidemiology, risk factors, associated conditions, and natural history of EoE in children and adults. Diagnostic conditions and criteria, the yield of diagnostic and disease monitoring procedures, and evidence-based statements and recommendation on the utility of the several treatment options for patients EoE are provided. Recommendations on how to choose and implement treatment and long-term management are provided based on expert opinion and best clinical practice.Evidence-based recommendations for EoE diagnosis, treatment modalities, and patients' follow up are proposed in the guideline.

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Epidemiology and Natural History of Eosinophilic Esophagitis

2017-08-01

Evan S. Dellon , Ikuo Hirano

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Updated International Consensus Diagnostic Criteria for Eosinophilic Esophagitis: Proceedings of the AGREE Conference

2018-09-06

Evan S. Dellon , Chris A. Liacouras , Javier Molina‐Infante +7 more

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ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications

2018-08-17

Christian Maaser , Andreas Sturm , Stephan R. Vavricka +7 more

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EOSINOPHILIC GASTROENTERITIS

1970-07-01

Neil C. Klein , Richard Hargrove , Marvin H. Sleisenger +1 more

KLEIN, NEIL C. M.D.; HARGROVE, R. LESLIE M.D.; SLEISENGER, MARVIN H. M.D.; JEFFRIES, GRAHAM H. M.R.C.P. KLEIN, NEIL C. M.D.; HARGROVE, R. LESLIE M.D.; SLEISENGER, MARVIN H. M.D.; JEFFRIES, GRAHAM H. M.R.C.P.

Eosinophilic Esophagitis

2015-10-22

Glenn T. Furuta , David A. Katzka

Eosinophilic esophagitis is an increasingly common diagnosis among children evaluated for feeding problems and among adults with dysphagia and food impaction. This review considers the diagnostic criteria, pathophysiology, clinical features, … Eosinophilic esophagitis is an increasingly common diagnosis among children evaluated for feeding problems and among adults with dysphagia and food impaction. This review considers the diagnostic criteria, pathophysiology, clinical features, and treatment of this disease.

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THE EOSINOPHIL

2005-11-05

Marc E. Rothenberg , Simon P. Hogan

Eosinophils have been considered end-stage cells involved in host protection against parasites. However, numerous lines of evidence have now changed this perspective by showing that eosinophils are pleiotropic multifunctional leukocytes … Eosinophils have been considered end-stage cells involved in host protection against parasites. However, numerous lines of evidence have now changed this perspective by showing that eosinophils are pleiotropic multifunctional leukocytes involved in initiation and propagation of diverse inflammatory responses, as well as modulators of innate and adaptive immunity. In this review, we summarize the biology of eosinophils, focusing on the growing properties of eosinophil-derived products, including the constituents of their granules as well as the mechanisms by which they release their pleiotropic mediators. We examine new views on the role of eosinophils in homeostatic function, including developmental biology and innate and adaptive immunity (as well as interaction with mast cells and T cells). The molecular steps involved in eosinophil development and trafficking are described, with special attention to the important role of the transcription factor GATA-1, the eosinophil-selective cytokine IL-5, and the eotaxin subfamily of chemokines. We also review the role of eosinophils in disease processes, including infections, asthma, and gastrointestinal disorders, and new data concerning genetically engineered eosinophil-deficient mice. Finally, strategies for targeted therapeutic intervention in eosinophil-mediated mucosal diseases are conceptualized.

Eosinophilic Esophagitis

2004-08-25

Richard J. Noel , Philip E. Putnam , Marc E. Rothenberg

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Correction to: <i>TTC7A</i> missense variants in intestinal disease can be classified by molecular and cellular phenotypes

2025-06-25

| Human Molecular Genetics

Magnitude, outcome, and predictors of mortality in perforated peptic ulcer disease: a retrospective study in Jigjiga town, Ethiopia

2025-06-24

Abdirahman Burale , Bedhaasa Beyene , Mariam A. Ahmed +4 more | World Journal of Emergency Surgery

Peptic ulcer perforation (PUP) is a surgical emergency and life-threatening complication affecting 2-10% of peptic ulcer disease (PUD) patients. Delayed diagnosis and surgical management are associated with significant morbidity and … Peptic ulcer perforation (PUP) is a surgical emergency and life-threatening complication affecting 2-10% of peptic ulcer disease (PUD) patients. Delayed diagnosis and surgical management are associated with significant morbidity and mortality. This study assessed the magnitude and outcome of PUP among patients operated on at two public hospitals in Jigjig town, Ethiopia. A 3-year hospital-based retrospective cross-sectional study was conducted on 130 patients operated for PUP at the study hospitals in Jigjig from April 1st, 2018, to July 30th, 2021. Data were collected from medical records. Bivariate analysis identified key factors impacting outcomes in PUP patients. The cohort had a male-to-female ratio of 8.7:1, and a mean age of 38 ± 13.3 years, with 48.8% smokers and 56.6% chat chewers. Duodenal perforations accounted for 93.7% of cases, with post-operative complications in 29.1% and an in-hospital mortality rate of 5.5%. Significant predictors of morbidity and mortality included advanced age (AOR 23.88), comorbidities (AOR 26.80), pre-operative hypotension (AOR 32.33), and delayed hospital presentation (AOR 30.10). Male predominance, younger age, high smoking and chat chewing rates, and primarily duodenal perforations are common in perforated peptic ulcer cases. Advanced age, comorbidities, pre-operative hypotension, and delayed hospital presentation significantly increase postoperative complications and mortality, emphasizing the need for timely intervention and targeted public health measures to improve patient outcomes. Early intervention and careful management of comorbidities are crucial to improve survival and reduce complications in patients with PUP.

Characteristics and Clinical Management of Eosinophilic Esophagitis in Australia: A National Survey

2025-06-22

Annabel Clancy , Andrew Swain , Eleanor J. Beck +2 more | Clinical & Experimental Allergy

Work Absenteeism in Inflammatory Bowel Disease Patients Related to Patient-Reported Anxiety Levels and Disease Activity: The IBD-GO-WORK Study

2025-06-20

Raffaele Pellegrino , Ilaria De Costanzo , Giuseppe Imperio +5 more | Journal of Clinical Medicine

Background/Objectives: Patients with inflammatory bowel disease (IBD), whether affected by Crohn’s disease (CD) or ulcerative colitis (UC), are burdened by disability and a reduced quality of life. The individual’s regular … Background/Objectives: Patients with inflammatory bowel disease (IBD), whether affected by Crohn’s disease (CD) or ulcerative colitis (UC), are burdened by disability and a reduced quality of life. The individual’s regular participation in daily working life is a key factor among its determinants. This work aims to quantify work absenteeism in patients with IBD, profiling it concerning specific demographic variables, the degree of disease activity, and the level of self-reported anxious symptoms. Methods: A cross-sectional observational study targeted patients with a known diagnosis of IBD with disease activity no greater than moderate who were either employed or engaged in regular student activities. Participants were administered the Beck Anxiety Inventory (BAI) for the assessment of anxious symptoms, the Patient-Reported Outcome 2 (PRO-2) for evaluating IBD disease activity, and the Health and Work Performance Questionnaire (HPQ) short form for the analysis of work absenteeism, measured both as absolute and relative over two time frames (the last 7 days and the last 4 weeks). Within the HPQ, Likert scale (0–10) questions were administered to assess self-perceived work productivity. Results: A total of 300 patients were included [median age 43.5 years, IBD (UC 55.7%, CD 44.3%, sex (males 54%, females 46%)], recording absolute absenteeism of 56 (36–76) and 2 (−8–20) hours lost over 4 weeks and 7 days, respectively. The factors associated with worse absolute and relative absenteeism (both at 7-days and 4-weeks) were having CD (p < 0.001), having previous surgery (p < 0.05), and, exclusively in the 4-week assessment, being female (p < 0.05) and a smoker (p < 0.05). The BAI demonstrated a moderate correlation with 4-week absolute absenteeism (ρ = 0.374, p < 0.001), progressively increasing with anxiety severity. Additionally, the BAI was an independent predictor of a 25% work productivity loss over 4 weeks (aOR: 1.1, 95% CI 1.06–1.142, β = 0.096, p < 0.001). Disease activity measured based on PRO-2 strongly correlated with 4-week (ρ = 0.53, p < 0.001) and 7-day (ρ = 0.47, p < 0.001) absolute absenteeism. Conclusions: In conclusion, work absenteeism in IBD patients may be driven by the IBD phenotype, sex, anxiety, and disease activity. Improving these parameters could enhance productivity.

Ultrastructural Evidence of Interactions Between Eosinophils and Mast Cells in Gastric Cancer: Considerations in AllergoOncology Research

2025-06-20

Rosario Alberto Caruso , Valerio Caruso , Luciana Rigoli | Gastrointestinal Disorders

Background/Objectives: AllergoOncology is a new field of study that investigates the relationship between allergic inflammation and cancer. Mast cells and eosinophils are two critical players in allergy reactions, where they … Background/Objectives: AllergoOncology is a new field of study that investigates the relationship between allergic inflammation and cancer. Mast cells and eosinophils are two critical players in allergy reactions, where they can interact and release bioactive granules. The electron microscope is an indispensable tool for analyzing membrane contacts and degranulation patterns in mast cells and eosinophils. The aim of the present ultrastructural study is to analyze the interactions between tumor-associated eosinophils and mast cells (TATEM) in nine cases of gastric cancer. Methods: Seventy-two gastric cancer samples were analyzed using light microscopy, and nine cases exhibiting TATEM were selected for additional examination by transmission electron microscopy. Results: In seven cases, there was direct interaction between non-activated eosinophils and mast cells demonstrating piecemeal degranulation and/or exocytosis. In cases 8 and 9, both cell types showed more advanced stages of degranulation. Mast cells exhibited either massive degranulation (anaphylactic type) or signs of recovery, while eosinophils displayed cytolysis, with or without extracellular trap formation (ETosis). The concurrent activation of both cell types may indicate a collaborative immune response that could affect tumor behavior. There was a trend toward an association with low-stage (I-II) gastric cancer in patients with TATEM, but this difference was not statistically significant (p = 0.06). Conclusions: This work is the first investigation to present ultrastructural evidence of the intimate relationship between degranulating mast cells and cytolytic eosinophils, with or without ETosis, in gastric cancer. These findings support the emerging field of AllergoOncology, which examines the role of allergy-like immune responses in tumor immunity.

Systematic Review: Variability in Definitions of Fibrostenosis in Eosinophilic Oesophagitis

2025-06-19

Claire Beveridge , Natalie Farha , Christina Hermanns +7 more | Alimentary Pharmacology & Therapeutics

ABSTRACT Background Fibrostenosis is a serious complication of eosinophilic oesophagitis, but there is a lack of consensus regarding its definition and assessment. This poses a barrier in clinical care and … ABSTRACT Background Fibrostenosis is a serious complication of eosinophilic oesophagitis, but there is a lack of consensus regarding its definition and assessment. This poses a barrier in clinical care and research. Aim To perform a systematic review to examine existing definitions and diagnostic methods of detection regarding fibrostenosis in eosinophilic oesophagitis. Methods We searched MEDLINE, Cochrane Library, EMBASE, Scopus, and Web of Science and included studies of paediatric and adult eosinophilic oesophagitis patients with fibrostenosis based on endoscopy, imaging, histopathology, functional studies, and biomarkers. We excluded studies with <10 patients. We chose fibrostenosis as the umbrella term, encompassing all definitions. Results We identified 230 studies. The four categories of fibrostenosis definitions were: (1) structural findings (stricture, rings, and/or narrowings) ( n =204, 88.7%), (2) histology ( n =85, 37.0%), (3) functional (functional lumen imaging probe) ( n =15, 6.5%), and (4) biomarkers ( n =7, 3.0%). Multiple definitions were used in 78 studies. Methods used to detect structural fibrostenosis included Eosinophilic Oesophagitis Endoscopic Reference Score fibrostenotic components, luminal diameter (endoscopy or imaging), need for dilation, and endoscopist or radiologist global impression. Methods used to detect histologic fibrostenosis included Eosinophilic Oesophagitis Histologic Scoring System lamina propria fibrosis, pathologist global impression, and basal zone hyperplasia. Methods used to detect functional fibrostenosis included distensibility and compliance. Conclusions Significant variability exists in definitions and diagnostic methods of detection regarding fibrostenosis in eosinophilic oesophagitis. Lack of agreement hampers progress in further investigating this complication. Development of consensus criteria is necessary to provide clarity for clinical care and research.

Correction: Clinical effectiveness of esophageal stricture dilation using an improved endoscopic attachment cap in adults with eosinophilic esophagitis

2025-06-18

Alain Schoepfer , Luc Biedermann , Andrea Kreienbuehl +6 more | Endoscopy

Dupilumab Efficacy in Children With Eosinophilic Esophagitis With Prior Swallowed Topical Corticosteroid Use: A Subgroup Analysis

2025-06-18

Mirna Chehade , Salvatore Oliva , Dhandapani Ashok +5 more | The American Journal of Gastroenterology

INTRODUCTION: Swallowed topical corticosteroids (STCs) are commonly used to treat eosinophilic esophagitis (EoE); however, not all patients respond, and others may be intolerant or have contraindications. We assessed dupilumab efficacy … INTRODUCTION: Swallowed topical corticosteroids (STCs) are commonly used to treat eosinophilic esophagitis (EoE); however, not all patients respond, and others may be intolerant or have contraindications. We assessed dupilumab efficacy in children with EoE with prior STC use, and with prior inadequate response/intolerance/contraindication (IRIC) to STCs in the phase 3 EoE KIDS study. METHODS: Eligible patients were aged 1–11 years with EoE unresponsive to proton-pump inhibitors. In Part A, patients were randomized to weight-tiered higher- or lower-exposure dupilumab, or placebo up to Week (W)16. In Part B, dupilumab groups continued treatment, while patients receiving placebo switched to higher- or lower-exposure dupilumab through W52. Efficacy by prior STC status was assessed at W16 and W52. RESULTS: Of 102 patients, 82 (80%) received prior STCs and 59 (58%) had prior IRIC to STCs. At W16, higher-exposure dupilumab improved rates of histologic remission vs placebo in patients with prior STC use (60.7% vs 0.0%, nominal P < 0.0001) and prior IRIC to STCs (60.9% vs 0.0%, nominal P < 0.0001). Secondary endoscopic and histologic outcomes were similar. Responses were maintained at W52 with higher-exposure dupilumab, with improvements observed in patients who switched from placebo to higher-exposure dupilumab. Results were similar or numerically lower with lower-exposure dupilumab. Findings appeared comparable in those without prior STC use or prior IRIC, although patient numbers were small. Dupilumab safety was consistent with the known safety profile. DISCUSSION: Dupilumab may be an effective treatment in children with EoE with prior STC use, or prior IRIC to STCs.

Response to Macias et al

2025-06-18

Griffith B. Perkins , Amanda Lim , Pravin Hissaria +1 more | The American Journal of Gastroenterology

The oesophagus as an immune organ

2025-06-18

Mark Rochman , Kendall Kellerman , Michael P. Jankowski +1 more | Nature Reviews Gastroenterology & Hepatology

Barriers to treatment adherence in pediatric eosinophilic esophagitis

2025-06-17

Julia Primo , George Tankosich , Kristen Critelli +1 more | JPGN Reports

ABSTRACT Objectives Treatment adherence in pediatric patients with eosinophilic esophagitis (EoE) is suboptimal. This study aimed to identify barriers to adherence, comparing experiences between patients on elimination diets and those … ABSTRACT Objectives Treatment adherence in pediatric patients with eosinophilic esophagitis (EoE) is suboptimal. This study aimed to identify barriers to adherence, comparing experiences between patients on elimination diets and those prescribed medication. Methods This observational study utilized a questionnaire incorporating elements from a previously validated medication adherence tool, in addition to studies assessing dietary and medication adherence in pediatric gastrointestinal disorders. Results A total of 125 patients were enrolled. Among them, 94 patients were prescribed medication, and 58 patients were prescribed dietary elimination, with 27 subjects receiving both medication and dietary elimination. High rates of nonadherence were observed in both groups. In the pharmacological group, the most common barrier was forgetting to take medication, particularly among those prescribed swallowed topical corticosteroids. In the dietary therapy group, limited food options and challenges when away from home were key barriers. Furthermore, older children, those unsupervised by parents, and those living in single or separate households exhibited lower adherence to dietary therapy. Conclusion Shared decision‐making between healthcare providers, patients, and their families is critical for optimizing treatment adherence in pediatric EoE. Our findings offer new insights into the barriers to dietary and pharmacologic treatment in pediatric EoE, and understanding and addressing these barriers may enhance long‐term treatment adherence and improve quality of life for this population.

Diseases of the upper gastrointestinal tract in pregnancy: what should the gastroenterologist consider?

2025-06-16

E P Yakovenko , Т.В. Строкова , Alexander N. Ivanov +2 more | Russian Journal of Evidence-Based Gastroenterology

Diseases of the upper gastrointestinal (GI) tract are among the most common extragenital pathologies in pregnant women. Hormonal and physiological changes occurring during pregnancy can trigger or exacerbate conditions such … Diseases of the upper gastrointestinal (GI) tract are among the most common extragenital pathologies in pregnant women. Hormonal and physiological changes occurring during pregnancy can trigger or exacerbate conditions such as gastroesophageal reflux disease (GERD), functional dyspepsia, chronic gastritis, and peptic ulcer disease. The rational selection of pharmacotherapy requires careful consideration of drug safety for both the mother and the fetus. Objective. To summarize current evidence-based data on the diagnosis, natural history, and treatment of the most common upper GI diseases in pregnant women. Key points. This review discusses major gastroenterological disorders in pregnant women, including their pathogenesis, clinical manifestations, and diagnostic methods. Approaches to treatment are outlined in accordance with international and national guidelines, with a particular focus on pharmacotherapy and the FDA drug safety classification system. Algorithms for patient management are presented, emphasizing risk minimization for the fetus while ensuring effective treatment for the mother. Conclusion. Early diagnosis and appropriate treatment of gastroenterological disorders in pregnant women can reduce complications and improve patient quality of life. The management of such cases requires a multidisciplinary approach involving both a gastroenterologist and an obstetrician.

Non-esophageal eosinophilic gastrointestinal disease and chronic abdominal pain in children: A multicenter experience

2025-06-16

Bhaswati C Acharyya , Meghdeep Mukhopadhyay , Hema Chakrabarty | World Journal of Clinical Pediatrics

BACKGROUND Eosinophilic gastrointestinal (GI) disease (EGID) beyond eosinophilic esophagitis is not commonly reported in the developing world. AIM To estimate the prevalence of EGID in a selected group of pediatric … BACKGROUND Eosinophilic gastrointestinal (GI) disease (EGID) beyond eosinophilic esophagitis is not commonly reported in the developing world. AIM To estimate the prevalence of EGID in a selected group of pediatric patients suffering from non-functional chronic abdominal pain (CAP). METHODS A retrospective analysis was conducted on case records of children with CAP. Those exhibiting clinical or laboratory alarming features underwent endoscopic evaluation. Histopathology reports from upper GI endoscopy and ileo-colonoscopy determined the diagnosis of EGID. Subsequent analyses included clinical presentations, presence of atopy in the children or family, hemoglobin, albumin, serum immunoglobulin E (IgE), fecal calprotectin levels, endoscopic appearances, treatment methods, and outcomes. RESULTS A total of 368 children with organic CAP were subjected to endoscopic evaluation. Among them, 19 (5.2%) patients with CAP were diagnosed with EGID. The median age of the children was 11.1 years (interquartile range = 8.4-14.4). The estimated prevalence of EGID in children with organic CAP was 520/10000 children over 5 years. Periumbilical pain was the most common site (63%). Family history of atopy, peripheral blood eosinophilia, and elevated serum IgE were the three parameters significantly associated with EGID. Clinical remission was obtained in all children at 6 months. The 47% had microscopic remission and maintained remission until a 1-year follow-up. The 53% had a fluctuating clinical course after 6 months. CONCLUSION EGID beyond the esophagus is not an uncommon entity among the children of India. It can contribute significantly to the etiology of pediatric CAP.

Swallowed topical steroid maintenance therapy for eosinophilic esophagitis: A systematic review and meta-analysis

2025-06-16

Yi-Zhong Wu , Megan Kudlak , Manuel Garza +6 more | World Journal of Meta-Analysis

BACKGROUND Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder presenting as symptoms of dysphagia, esophageal food impaction, chest pain, and heartburn. After an initial trial of proton pump inhibitor (PPI) … BACKGROUND Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder presenting as symptoms of dysphagia, esophageal food impaction, chest pain, and heartburn. After an initial trial of proton pump inhibitor (PPI) therapy, swallowed topical corticosteroids (STC) are effective as induction therapy for EoE. However, outcome data for STC as a maintenance strategy is limited. AIM To systematically evaluate the long-term outcomes and safety of maintenance treatment with STC. METHODS A systematic search of PubMed, EMBASE, Cochrane, and Web of Science was performed from inception to January 2025 for studies comparing long term or maintenance treatment with STC for EoE compared to placebo. We included studies that investigated patients who underwent successful induction therapy. Pooled data was analyzed for histologic recurrence, symptom recurrence, need for repeat esophageal dilation, use of concomitant PPI, and candida infection rates. A random effects model was used, and the data was presented using odds ratios (OR) with 95% confidence intervals (CI). RESULTS Three randomized control trials and one observational study were included, involving 303 patients (189 in the STC group, 114 in the placebo-controlled group). Analysis showed that histologic recurrence was significantly lower with STC (OR: 0.04, 95%CI: 0.01-0.28, P < 0.00001, I 2 = 78%). Overall symptom recurrence was similar between groups (OR: 0.23, 95%CI: 0.02-3.54, P = 0.29, I 2 = 92%). On sensitivity analysis, symptom recurrence was significantly lower in the STC group (OR: 0.05, 95%CI: 0.02-0.17, P = 0.00001, I 2 = 39%). Odds of repeat dilation were significantly lower in the STC group (OR: 0.14, 95%CI: 0.02-0.91, P = 0.04, I 2 = 0%). Candida infection rates were similar between groups (OR: 6.13, 95%CI: 0.85-44.26, P = 0.07, I 2 = 24%). Proportion of concomitant PPI use was similar between groups (OR: 1.64, 95%CI: 0.83-3.21, P = 0.15, I 2 = 0%). CONCLUSION For patients who successfully achieved remission of EoE with STC induction therapy, maintaining treatment is effective in sustaining histologic remission, while newer regimens may be effective in preventing symptom recurrence compared to placebo. We found no significant difference for oropharyngeal/esophageal candidiasis with STC maintenance therapy. Future studies with longer follow-up periods are needed.

Editorial: Current trends and future management of IBD, volume II

2025-06-16

Sérgio Bronze , Iago Rodríguez‐Lago , Triana Lobatón +1 more | Frontiers in Medicine

Eosinophilic gastritis, enteritis, and colitis: understudied subtypes within the spectrum of eosinophilic gastrointestinal disorders. A literature review

2025-06-16

V. O. Kaybysheva , S. V. Shchelochenkov , Tatjana Schelochenkova +7 more | Russian Journal of Evidence-Based Gastroenterology

Objective. In recent years, several key consensus documents have been published on eosinophilic gastrointestinal disorders (EGIDs). This review aims to analyze the literature and discuss core concepts, including terminology and … Objective. In recent years, several key consensus documents have been published on eosinophilic gastrointestinal disorders (EGIDs). This review aims to analyze the literature and discuss core concepts, including terminology and classification, etiology, pathogenesis, and treatment of eosinophilic gastritis, enteritis, and colitis. Key points. Eosinophilic gastrointestinal disorders are a group of immune-mediated diseases of unknown etiology, characterized by eosinophilic infiltration of the walls of hollow gastrointestinal organs—from the mucosa to the serosa—resulting in significant clinical symptoms, endoscopic findings, and, in some cases, complications such as perforation, bleeding, ascites, or intestinal obstruction. The first consensus document on EGIDs (2022) proposed standardized nomenclature based on the affected site: eosinophilic esophagitis, eosinophilic gastritis, eosinophilic enteritis, and eosinophilic colitis. The clinical presentation is highly variable and non-specific, depending on the depth of inflammation (mucosal, muscular, or serosal). Validated endoscopic criteria for eosinophilic involvement of the stomach and intestines are not currently available. Diagnosis of eosinophilic gastritis, enteritis, or colitis is based on clinical presentation, endoscopic findings, and multifocal mucosal biopsy followed by histological evaluation. There are no established treatment guidelines; empiric approaches include systemic and topical glucocorticoids, biologic therapies, and elimination diets. Conclusion. The diagnosis of eosinophilic gastric and intestinal diseases remains challenging due to non-specific clinical and endoscopic features and the absence of clear histopathological criteria. These conditions are rare and not widely recognized in clinical practice. Current treatment strategies include dietary therapy, corticosteroids, and targeted biologic agents.

High-accuracy eosinophil detection in eosinophilic esophagitis histological images using machine learning model YOLO11

2025-06-16

А. В. Астафьев , Ksenia Maslenkina , Л.М. Михалева +7 more | Russian Journal of Evidence-Based Gastroenterology

Objective. To evaluate the effectiveness of the YOLO11 machine learning model for automated segmentation and detection of eosinophils in histological images in order to improve the diagnostic accuracy of eosinophilic … Objective. To evaluate the effectiveness of the YOLO11 machine learning model for automated segmentation and detection of eosinophils in histological images in order to improve the diagnostic accuracy of eosinophilic esophagitis (EoE). Materials and Methods. A multicenter retrospective analysis was conducted using histological images obtained through whole slide imaging (WSI) from 60 patients diagnosed with EoE. Out of 653 tissue section images, 54 were manually annotated and reviewed. The annotated dataset was then used to train the YOLO11 model. Results. By the 150th training epoch, the model demonstrated consistent improvement in precision and recall for bounding boxes detection. The final recall value reached 0.98, indicating a very high sensitivity of the model to the target areas (i.e., eosinophils) within the histological slides. The Intersection over Union (IoU) score peaked at 0.94, reflecting the model’s robust performance in accurately localizing and segmenting eosinophils. Furthermore, the model exhibited strong precision and recall not only for bounding boxes but also for segmentation masks, reinforcing its capability to delineate eosinophil boundaries. However, performance evaluation on new, unannotated images revealed several limitations requiring further optimization, particularly a decrease in effectiveness when analyzing clusters of eosinophils. Conclusion. The YOLO11-based approach developed in this study represents a significant advancement in the automation of histological assessment for EoE, offering a highly accurate tool for eosinophilic infiltration analysis. Future research directions include expanding the annotated WSI dataset, refining the model through additional training, and exploring the application of vision transformer-based architectures. The results of eosinophil segmentation and peak eosinophil count (PEC) will require retrospective validation against values determined by pathologists through light microscopy.

Inhalation and inflammation: examining aeroallergens and eosinophilic esophagitis

2025-06-16

S. Sekar , K. Lee Kelly , Dipa Sheth +1 more | Frontiers in Allergy

Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease leading to inflammation in the esophageal lining. EoE has become a significant cause of gastrointestinal illness in both children and adults. While … Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease leading to inflammation in the esophageal lining. EoE has become a significant cause of gastrointestinal illness in both children and adults. While there is significant focus on dietary triggers in the pathophysiology of the disease, aeroallergens are also increasingly implicated in both the development and clinical presentation. Possible mechanisms, seasonality and current evidence for the role of aeroallergens in EoE are discussed, including seasonality, allergen specific mechanisms and therapeutic options. A multidisciplinary team between allergists and gastroenterologists is optimal for coordinated patient management.

<b>BEYOND STANDARD CARE: CURCUMIN AS COMBINATION THERAPY IN INFLAMMATORY BOWEL DISEASE: A SYSTEMATIC REVIEW</b>

2025-06-14

Muhammad Rafiq , Mahmoodur Rehman , Abdul Basit +5 more | Journal of medical & health sciences review.

Background: Inflammatory Bowel Disease (IBD), comprising ulcerative colitis (UC) and Crohn’s disease (CD), is a chronic gastrointestinal disorder marked by inflammation. Curcumin, derived from turmeric, is known for its anti-inflammatory … Background: Inflammatory Bowel Disease (IBD), comprising ulcerative colitis (UC) and Crohn’s disease (CD), is a chronic gastrointestinal disorder marked by inflammation. Curcumin, derived from turmeric, is known for its anti-inflammatory properties. This systematic review aims to assess the efficacy and safety of curcumin as adjunct therapy in IBD treatment. Methods: A comprehensive search across multiple databases (PubMed, Embase, Cochrane Library, Scopus, Web of Science, CNKI, and ClinicalTrials.gov) was conducted up to April 2025 using search string was used: ("Curcumin"[Mesh] OR curcumin[tiab]) AND ("Inflammatory Bowel Diseases"[Mesh] OR "inflammatory bowel disease"[tiab] OR IBD[tiab] OR "ulcerative colitis"[tiab] OR "Crohn's disease"[tiab]) AND ("Drug Therapy, Combination"[Mesh] OR "combination therapy"[tiab] OR "adjunct therapy"[tiab] OR "combined treatment"[tiab]). Randomized controlled trials (RCTs) assessing curcumin in combination with standard IBD treatments were included. Data were extracted and quality assessment was done through RoB2. Results: In this systematic review of 13 randomized controlled trials involving 1,150 participants, curcumin was administered orally or rectally as an adjunct to standard therapies. It demonstrated a consistent benefit in patients with inflammatory bowel disease specifically targeting ulcerative colitis. Ten studies reported significantly higher rates of clinical remission in curcumin-treated groups, while eight showed endoscopic improvement, particularly with advanced or rectal formulations. Improvements in quality of life were noted in four trials, though evidence remained limited. Across all studies, curcumin was well tolerated, with no significant increase in adverse events compared to controls. Only one pilot study addressed Crohn’s disease, indicating possible benefit but with very low certainty. Overall, curcumin appears effective and safe as an adjunct therapy in mild-to-moderate UC, with moderate-certainty evidence supporting its role in clinical remission and mucosal healing. Conclusion: Curcumin appears to improve treatment outcomes in inflammatory bowel disease specifically ulcerative colitis when used alongside standard therapy, without increasing adverse effects. Future high-quality RCTs are necessary to further evaluate curcumin's potential in its treatment.

Initial misdiagnosis of gastritis cystica profunda: Two case reports

2025-06-13

Xiao-Li Zheng , Long Xu , Jun Wang | World Journal of Clinical Cases

BACKGROUND Gastritis cystica profunda (GCP) is a rare gastric disorder. It is characterized by non-specific symptoms and diagnostic complexity. This case report enriches the medical literature by highlighting challenges in … BACKGROUND Gastritis cystica profunda (GCP) is a rare gastric disorder. It is characterized by non-specific symptoms and diagnostic complexity. This case report enriches the medical literature by highlighting challenges in diagnosing and treating GCP. CASE SUMMARY Two patients presented with non-specific abdominal symptoms, such as abdominal distension and epigastric discomfort. Initial misdiagnosis occurred due to GCP’s non-typical manifestations. After thorough investigations, GCP was diagnosed. Endoscopic mucosal resection and endoscopic submucosal dissection were carried out. Both patients recovered uneventfully. CONCLUSION GCP diagnosis demands caution, and endoscopic treatment is effective.

A case of eosinophilic gastritis with distinctive endoscopic findings

2025-06-13

Masao Kusano , Shinichi Ikeya , Tomoyuki Ikeda +1 more | Progress of Digestive Endoscopy

2191-LB: A First-in-Class FTO Small Molecule Inhibitor Preserves the Lean Mass during Long-Term Weight Control Comparable to GLP-1

2025-06-13

Yu Yan | Diabetes

Introduction and Objective: FTO gene is widely demonstrated to be associated with obesity and fat mass accumulation by past GWAS and mutation studies. We developed a novel FTO small molecule … Introduction and Objective: FTO gene is widely demonstrated to be associated with obesity and fat mass accumulation by past GWAS and mutation studies. We developed a novel FTO small molecule inhibitor targeted to provide a novel obesity drug solution. Methods: The weight control efficacy of the compound was evaluated in animal by comparing with Semaglutide. Results: The compound shows 20% weight loss comparable to Semaglutide, while favorably preserving the lean mass (Figure 1). Combination study even shows a synergistic effect between FTOi and GLP-1 (Figure 2). Animal tox study demonstrates the compound safety. Conclusion: Our FTOi, as a novel small molecule inhibitor, demonstrates it has comparable weight control efficacy as GLP-1, while preserving the lean mass. The clinical Phase I study will start at the end of 2025. Disclosure Y. Yan: None.

Abstract P4-01-16: Comprehensive Genomic Characterization of ILC Organoids: A BCRF Legacy Project Initiative

2025-06-13

Jagmohan Hooda , Jian Chen , Daniel D. Brown +7 more | Clinical Cancer Research

Abstract Background: Invasive lobular carcinoma (ILC) is a distinct histologic type of breast cancer with unique features. The lack of well-characterized ILC organoid models has limited research and therapy development. … Abstract Background: Invasive lobular carcinoma (ILC) is a distinct histologic type of breast cancer with unique features. The lack of well-characterized ILC organoid models has limited research and therapy development. We aim to establish a well-characterized ILC organoid biobank under the BCRF Legacy Project, creating a valuable resource for ILC research. Methods: We performed whole-genome (WGS) and RNA-sequencing (seq) on patient FFPE tumor tissues. ILC organoids are subjected to whole-exome (WES), bulk RNA-seq, single cell (sc)RNA-seq, scATAC-seq, and MSK-IMPACT targeted sequencing. STR profiling confirmed specimen relatedness. Data were analyzed using validated bioinformatics tools. Immunofluorescence (IF) analysis of E-cadherin and p120 was performed. Results: After establishing a total of 9 ILC organoids, WES was performed on all 9 organoids while WGS was performed on 2 patient samples corresponding to 2 of these organoids. WGS analysis of bilateral ILCs (TP19-M179), corresponding to LIO-046 organoid, revealed that both tumors shared a CDH1 p.L333Wfs23 frameshift mutation coupled with loss-of-heterozygosity (LOH), concurrent 1q gain and 16q loss, and dominant aging/clock mutational signatures. The left ILC was found to have fewer copy number alterations and somatic mutations than the right ILC. LIO-046 organoid was generated from right breast tumor tissue. Organoid IPM-BO-084 was generated from left ovarian metastasis of a mixed ILC (TP20-M130). Based on WGS analysis, the primary invasive carcinoma and ovarian metastases were found to be characterized by a somatic BRCA2 p.Q2157Ifs18 mutation associated with LOH, and displayed genomic features of homologous recombination deficiency (HRD). The levels of chromosomal instability were higher in ovarian metastases compared to the primary lesion. WES analysis of ILC organoid models identified genetic alterations affecting CDH1, which correlated with IF data where frameshift or nonsense mutations were associated with loss of E-cadherin and cytoplasmic p120 expression. Conclusions: We successfully established long-term ILC organoids. Our comprehensive genomic analysis of ILC organoids and patient samples underscores the genomic heterogeneity of ILC. Advanced sequencing techniques provide a framework for understanding ILC's molecular landscape. As we expand our biobank, these organoids and their data will be invaluable for developing targeted therapies and advancing ILC research. We are committed to making the genomic data and organoid models available to the research community. Our future goal is to foster collaboration and accelerate advancements in ILC research through this shared resource. Citation Format: Jagmohan Hooda, Jian Chen, Daniel D. Brown, Rohit Bhargava, David N Brown, Pier Selenica, Kaitlyn Gill, Hunter Green, Britta Weigelt, Adrian Lee, Steffi Oesterreich. Comprehensive Genomic Characterization of ILC Organoids: A BCRF Legacy Project Initiative [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P4-01-16.

Eosinophilic gastroenteritis in a 14-year-old patient with Noonan syndrome with a PTPN11 variation: a case report

2025-06-13

Nobuhiko Koga , Shuichi Yatsuga , Kei Kubota +3 more | Journal of Medical Case Reports

Cryoablation for Barrettʼs esophagus with dysplasia and eosinophilic esophagitis: A novel approach for a rare dual condition

2025-06-13

Dario Quintini , Caterina Stornello , Monica Franco +4 more | Endoscopy

Association of Increased Epstein–Barr Virus Reactivation With Imbalanced Immunity and Myenteric Neuron Loss in Achalasia

2025-06-12

Liyun Ma , Ling Du , Lu Yao +7 more | Journal of Gastroenterology and Hepatology

ABSTRACT Background and aim Viral infection has been postulated as a potential etiology of achalasia, yet the definitive role of viral involvement remains elusive. This study aims to elucidate virus … ABSTRACT Background and aim Viral infection has been postulated as a potential etiology of achalasia, yet the definitive role of viral involvement remains elusive. This study aims to elucidate virus infections and to analyze their relationships with clinical characteristics, immunological alterations, and neuron loss. Methods We investigated viral infections in achalasia patients ( n = 288) and controls ( n = 71). Propensity score matching (PSM) was employed to mitigate selection bias. Flow cytometry and ELISA were performed to characterize the immunological changes. In situ hybridization and immunofluorescence staining were used to detect viral infections within lower esophageal sphincter (LES). Results No significant differences in the infection rates of HSV‐1, HSV‐2, CMV, or EBV were detected between two groups. Notably, EBV reactivation was greater in patients with achalasia than in controls (15.3% vs. 5.6%, p = 0.032), especially in Type I achalasia (21.0% vs. 5.6%, p = 0.008). Following PSM, EBV reactivation was associated with an increase in B cells ( p = 0.001), a decrease in NK cells ( p = 0.005), and lower levels of IL‐6 ( p = 0.02) and IL‐8 ( p = 0.05). Additionally, EBV reactivation group presented a greater EBV infection rate in LES (68.8% vs. 31.3%, p = 0.034), which was associated with increased neuron loss. EBV infection was detected in B and T cells of the LES, rather than neurons. Conclusions Although relatively low, our findings reveal an increased frequency of EBV reactivation in patients with achalasia, which may be associated with imbalanced immunity and neuron loss in LES in these subpopulations. This study provides novel insights into the role of EBV reactivation in achalasia.

Hyper Infection with Strongyloides stercoralis in a Case of Gastric Outlet Obstruction Leading to Upper GI Haemorrhage: A Case Report

2025-06-12

Amit Awasthi , Jignesh Gandhi , Pravin Shinde | Asian Journal of Research in Infectious Diseases

Aims: Strongyloidiasis is an asymptomatic disease caused by the intestinal helminth Strongyloides stercoralis in immunocompetent individuals and are present for decades. The rarity of our case presents in the facts … Aims: Strongyloidiasis is an asymptomatic disease caused by the intestinal helminth Strongyloides stercoralis in immunocompetent individuals and are present for decades. The rarity of our case presents in the facts that an elderly gentleman being immunocompetent before, being evaluated for a surgical condition, circumstances lead to sudden deterioration and within one day of the biopsy report succumbs to the condition. While undergoing retrospective evaluation it was diagnosed as hyper infection and disseminated strongyloidiasis. Presentation of the Case: 77 year old elderly male , a case of chronic idiopathic demyelinating neuropathy(recovered) , previously was on oral steroids for a period of 1-2 months; was admitted with persistent vomiting at other hospital, and on evaluation diagnosed with hiatus hernia with severe gastritis and referred to us, patient underwent Naso jejunal tube placement in view of gastric outlet obstruction and for feeding, post which, patient had initially loose stools and thereafter malena, upper Gi scopy with cessation of bleed done, to recur as hematemesis and within one day of diagnosis of duodenal biopsy suggestive of Strongyloides stercoralis, patient succumbed to the disease. Discussion: The case emphasizes on the importance of evaluation of various gastrointestinal infections especially caused by pathogens in our country with tropical climate and need to correlate the immunocompetency of patient especially on steroids with underlying infections. Conclusion: strongyloidiasis infection should be ruled out in all the immunodeficient patients especially on steroids for brief periods and presenting with gastrointestinal symptoms of vomiting and diarrhoea.

Targeted Nano delivery Systems for Natural Antioxidants in ferulic acid Gastric Ulcer Management: Insights and Innovations

2025-06-10

Chetan Belwal , Dheeraj Bisht , Mrigankadeep Bharadwaj +1 more | Journal of Neonatal Surgery

Gastric ulcers, a prevalent manifestation of peptic ulcer disease, are largely influenced by oxidative stress arising from reactive oxygen species (ROS). Natural antioxidants such as ferulic acid, curcumin, quercetin, and … Gastric ulcers, a prevalent manifestation of peptic ulcer disease, are largely influenced by oxidative stress arising from reactive oxygen species (ROS). Natural antioxidants such as ferulic acid, curcumin, quercetin, and resveratrol have demonstrated promising gastroprotective effects through their antioxidant, anti-inflammatory, and cytoprotective actions. However, their clinical utility is hindered by poor solubility, instability in gastric environments, and limited bioavailability. Targeted nano delivery systems including polymeric nanoparticles, solid lipid nanoparticles, nanostructured lipid carriers, liposomes, and dendrimers offer innovative solutions to these challenges. These nanocarriers enhance drug solubility, protect active compounds from degradation, improve mucoadhesion, enable controlled release, and facilitate site-specific delivery. This review explores the mechanisms by which nanoparticles aid in ulcer healing, evaluates various nanocarrier types employed for antioxidant delivery, and highlights case studies, particularly ferulic acid-based systems. It also addresses the translational hurdles and future directions in nano formulation-based therapy for gastric ulcer management. The integration of nanotechnology with natural antioxidant therapy holds substantial promise for advancing the efficacy and precision of ulcer treatments.

Guselkumab (Tremfya) - an IL-23 antagonist for Crohn's disease.

2025-06-09

| PubMed

Inflammatory oesophagogastric polyp

2025-06-06

Frank Gaillard | Radiopaedia.org

Current concepts of chronic gastritis and gastropathies: new international consensus RE.GA.IN. Review

2025-06-06

С. М. Ткач , N. V. Kharchenko , A. E. Dorofeyev +1 more | Modern Gastroenterology

Recent decades have been marked by several important milestones in the field of gastritis. New epidemiological reports were received, especially from countries with a high incidence of gastric cancer, and … Recent decades have been marked by several important milestones in the field of gastritis. New epidemiological reports were received, especially from countries with a high incidence of gastric cancer, and H. pylori infection was recognized as the most important cause of gastritis, due to which it was quickly included among the primary infectious oncogenic agents. Clinical strategies for the detection and eradication of H. pylori infection were developed, the previously unsuspected clinical and pathological significance of the gastric microbiota was established, and extraordinary progress was made in the technology of esophagogastroduodenoscopy. Histological determination of gastritis from the point of view of «stage» (that is, risk stratification of stomach cancer) has entered clinical practice. In addition to the Sydney and Houston gastritis classifications, six editions of the Maastricht Consensus (1996—2022) and the Kyoto Global Consensus deserve special attention, thanks to which agreements were reached in the most controversial issues of the entire spectrum of gastritis, with a special emphasis on H. pylori gastritis, which accounts for more than 90% of all forms of gastritis worldwide. The Real‑world Gastritis Initiative (RE.GA.IN) marks the next step in the ongoing quest to achieve a better understanding of various gastric conditions. The RE.GA.IN consensus was concluded in Venice in November 2022 after 8 months of intensive global scientific reasoning. RE.GA.IN’s mission itself has been focused on critically reviewing, updating, sharing and building consensus on the current scientific knowledge of inflammatory gastric lesions. It includes eight sections on clinicopathological topics, each consisting of preamble, which briefly presents the following statements and corresponding explanatory texts. For each statement, the level of evidence (assessed according to a predefined four‑level scale) and the strength of recommendations according to the GRADE system are reported. The following topics were considered in the consensus: 1) definition and problem of classification of gastritis; 2) spectrum of H. pylori gastritis; 3) key diagnosis of H. pylori gastritis; 4) H. pylori gastritis: clinical results; 5) autoimmune gastritis; 6) gastritis of low prevalence; 7) gastritis and gastric microbiota; 8) epidemiology of gastritis and associated precancerous and neoplastic lesions. Thus, the most controversial aspects of gastritis were addressed and a comprehensive and diverse body of knowledge was brought together to use patient‑oriented evidence to assist physicians in their clinical practice.

Gastric-shaped Esophagus in Achalasia

2025-06-05

Guan Fu , Shengbing Wang | The American Journal of Gastroenterology