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Relapse in Eosinophilic Esophagitis Occurs Despite Treatment With Swallowed Topical Corticosteroids

Swallowed topical corticosteroids (STC) are effective as initial treatment in patients with eosinophilic esophagitis (EoE) and in achieving histological remission. However, their role in the

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Neoplasia Detection Rate in Barrett’s Esophagus: A Measure of High-Quality Upper Endoscopy

Studies have reported that up to 25% of esophageal adenocarcinomas (EACs) are detected within 1 year of index endoscopy (missed cancer), emphasizing the need for

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Budesonide Can Be Used for Maintaining Long-Term Remission in Eosinophilic Esophagitis

Eosinophilic esophagitis (EoE) is a chronic antigen-mediated immunological disorder that has a high relapse rate of >80% with cessation of therapy. Although corticosteroids (both topical

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Implementing a Standardized Protocol Helps to Increase Diagnosis of Eosinophilic Esophagitis

The incidence of eosinophilic esophagitis (EoE), a condition characterized by esophageal eosinophilia and dysfunction, has been reported in about 5 to 10 per 100,000 individuals.

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Motility Disorders Can Exist in Patients With Eosinophilic Esophagitis, Specifically in Those Not Responding to Therapy

Eosinophilic esophagitis (EoE) is characterized by the presence of esophageal dysfunction along with histological evidence of ≥15 eosinophils per high-power field from esophageal biopsies. Recent

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Dysphagia Is Common After Bariatric Surgery

Symptoms of dysphagia due to obstruction (mechanical or functional) can be caused by a noncompliant gastric pouch after bariatric surgery and, theoretically, could lead to

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Nonendoscopic Screening for Barrett’s Esophagus: Are We There?

Upper endoscopy (EGD) with biopsy remains the gold standard for the diagnosis of Barrett’s esophagus (BE). Several nonendoscopic techniques (sponge, capsule) have utilized biomarkers, such

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Peroral Endoscopic Myotomy Can Be Safe and Effective for Persistent Symptoms After Heller Myotomy

Persistent and recurrent symptoms have been reported in up to 20% of patients with achalasia after surgical treatment with Heller myotomy. The aim of this

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Is Barrett’s Esophagus Thickness a Marker for Response to Radiofrequency Ablation Therapy?

Radiofrequency ablation (RFA) is a widely used modality for treating flat Barrett’s esophagus (BE) dysplasia, with the goal of achieving complete eradication of intestinal metaplasia

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Is Obesity a Risk Factor for Barrett’s Esophagus?

While the role of obesity in gastroesophageal reflux disease (GERD) and the role of GERD in Barrett’s esophagus (BE) are independently well established, there is

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Use of a Magnetically Assisted Capsule Device for Examining the Esophagus

The magnetically assisted capsule endoscopy (MACE) system (MicroCam Navi; IntroMedic) is a novel noninvasive technique for visualizing the upper GI tract. This device utilizes a

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ESD Versus EMR for Resecting Esophageal Neoplasia

Endoscopic submucosal dissection (ESD) is an effective method of resecting larger superficial esophageal lesions en bloc; however, it is fraught with advanced training needs, longer

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Which Upper GI Findings During EGD Do Not Require Follow-Up?

The European Society of Gastrointestinal Endoscopy (ESGE) has issued recommendations on conditions that do not require routine surveillance. Those related to upper GI endoscopy include:

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Is Cryoballoon Ablation Ready for Barrett’s Endoscopic Therapy?

The 90˚-swipe cryoballoon ablation system (CbSAS90) is a new technology incorporating cryotherapy that has been proposed to treat Barrett’s esophagus (BE) segments. This technology is

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What Therapy to Use for Patients With EoE: PPIs, Steroids, or Elimination Diets?

Prateek Sharma, MD, FASGE, reviewing Laserna-Mendieta EJ, et al. Clin Gastroenterol Hepatol 2020 Jan 25. Proton pump inhibitors (PPIs), steroids, elimination diets, and esophageal dilation

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Bile Acid Sequestrants Demonstrate Significant Benefit As Adjunctive Therapy in Refractory GERD

Prateek Sharma, MD, FASGE, reviewing Vaezi MF, et al. Gastroenterology 2020 Feb 21. Proton pump inhibitor- (PPI) refractory GERD, accounting for about one-third of all

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Patients With Barrett’s Esophagus and Indefinite Dysplasia: What To Do?

Prateek Sharma, MD, FASGE, reviewing Krishnamoorthi R, et al. Gastrointest Endosc 2020 Jan. The risk of progression in Barrett’s esophagus (BE) with low-grade dysplasia has

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The Battle Zone of Barrett’s Endoscopic Therapy: The Gastric Cardia

Prateek Sharma, MD, FASGE, reviewing Eluri S, et al. Clin Gastroenterol Hepatol 2020 Jan. Long-term durability of complete eradication of intestinal metaplasia (CE-IM) is the

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Dupilumab: A New Treatment Option for Patients With Eosinophilic Esophagitis

Prateek Sharma, MD, FASGE, reviewing Hirano I, et al. Gastroenterology 2020 Jan. Medical treatment options for patients with eosinophilic esophagitis (EoE) include proton pump inhibitors,

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Physician and Patient Education Can Lead to Reduction in Inappropriate PPI Use

Prateek Sharma, MD, FASGE, reviewing Lin D, et al. Clin Gastroenterol Hepatol 2019 Dec 27. The use of proton pump inhibitors (PPIs) for the treatment

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POEM Versus Surgery for Achalasia Treatment: Which One To Select?

Prateek Sharma, MD, FASGE reviewing Werner YB, et al. N Engl J Med 2019 Dec 5. Both peroral endoscopic myotomy (POEM) and surgical laparoscopic Heller’s

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Does Prior Treatment Impact Outcomes of POEM in Patients With Achalasia?

Prateek Sharma, MD, FASGE reviewing Liu ZQ, et al. Endoscopy 2019 Apr. The major treatment options for achalasia include laparoscopic Heller myotomy, pneumatic balloon dilation,

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1% Lugol’s Iodine Solution Should Be Used for Esophageal Chromoendoscopy

Prateek Sharma, MD, FASGE reviewing Gotoda T, et al. Gastrointest Endosc 2019 Oct 25. Lugol’s iodine has been utilized for dye-spray chromoendoscopy to detect esophageal

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Medical Versus Surgical Treatment for Refractory Heartburn: What Should You Do?

Prateek Sharma, MD, FASGE reviewing Spechler SJ, et al. New Engl J Med 2019 Oct 17. Although proton pump inhibitors (PPIs) are widely utilized for

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How to Manage PPI-Refractory Regurgitation

Prateek Sharma, MD, FASGE reviewing Bell R, et al. Clin Gastroenterol Hepatol 2019 Sep 10. Magnetic sphincter augmentation (MSA) uses a series of titanium beads

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Patients With Eosinophilic Esophagitis Need Long-Term Treatment

Although it is known that eosinophilic esophagitis (EoE) is a chronic disease and recurs if treatment is discontinued, the rates of recurrence and the impact

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Are Potassium-Competitive Acid Blockers Superior to PPIs for GERD Treatment?

Proton pump inhibitors (PPIs) are widely used for the treatment of GERD, including healing erosive esophagitis. Since several PPIs have a slow, cumulative onset of

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