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Approaches to management of eosinophilic esophagitis (EoE) continue to evolve. In the current article, an expert in the field offers pragmatic clinical pearls for managing EoE. Highlights are as follows:
A validated endoscopic scoring system to standardize reporting is recommended for diagnosis and assessment of treatment response. This tool is available in a dropdown menu in the commonly used Provation endoscopic report system.
Proton-pump inhibitor (PPI)–responsive eosinophilia is not distinguishable from EoE by symptoms, endoscopic findings, histology, or genetics.
In patients with suspected EoE for whom PPIs reduce but do not normalize histologic eosinophilia, continue PPIs and add medical or diet therapy. If no histologic improvement occu…