Gastroenterology

Esophageal Disorders

Questions discussed in this category

In patients on long-term proton pump inhibitors for GERD with stable symptoms, do you routinely attempt discontinuation or continue indefinitely given relapse risk?

If you trial discontinuation, what is your approach to tapering?

3 Answers available

How do you diagnose and manage suspected opioid-induced esophageal dysfunction?

1 Answer available

What patient characteristics guide the selection of a step-up versus a step-down elimination diet strategy in the management of eosinophilic esophagitis?

New ACG guidelines on EOE:Dellon et al., PMID 39745304

1 Answer available

What are the target distensibility index and EGJ diameter values on EndoFLIP following peroral endoscopic myotomy (POEM)?

Which size catheter and volume do you use to measure the DI and diameter intra-op post POEM?

1 Answer available

How do you approach surveillance and repeat biopsies in a patient with a diagnosis of intestinal metaplasia (aka Barrett's esophagus) on pathology who appears to have a regular Z-line or <1 cm of salmon mucosa?

(Especially in cases where you did not do the index endoscopy)

2 Answers available

How would you approach endoscopic diagnosis and treatment of an area of visible nodularity concerning for cancer within long segment Barrett’s esophagus?

1 Answer available

How will the findings from the recent BOSS study affect your management of Barrett's esophagus without dysplasia?

Will you change your surveillance interval? Old et al., PMID 40180292

1 Answer available

In patients with EGJOO on esophageal manometry, how do you approach subsequent testing for further evaluation?

2 Answers available

What Barrett's Esophagus screening protocol do you follow for patients with scleroderma given the increased risk of reflux and esophageal stasis?

1 Answer available

What therapies would be considered safe and effective in pregnant patients with EoE?

2 Answers available

Do you prescribe respiratory muscle training (RMT) devices to patients with dysphagia?

The controlled trial below demonstrated improvement in dysphagia among Parkinson's patients. Might this have greater potential for benefit than modifi...

1 Answer available

How do you approach a referral for findings of intestinal metaplasia on a biopsy of an irregular z-line?

2 Answers available

How would you manage an elderly patient with type 3 achalasia who previously underwent POEM and has recurrent dysphagia, high Eckardt score, and dilated esophagus concerning for blown-out myotomy on esophagram?

Would you recommend repeat POEM, Heller myotomy, or pneumatic dilation?

1 Answer available

How would you manage long-segment Barrett's esophagus with both LGD and HGD that has failed to respond to RFA, cryoablation, or even Nissen fundoplication for large hiatal hernia?

3 Answers available

How do you practically approach a tailored elimination diet in young patients with numerous food impactions and esophageal strictures who are intermittently compliant with PPI or topical steroids?

How do you practically approach a tailored elimination diet in young patients with numerous food impactions and esophageal strictures who are intermit...

1 Answer available

Is there a role for use of dupilumab for hypereosinophilic GI disorders distal to the esophagus?

2 Answers available

Is there a role for anti-IL5 therapy in the treatment of EoE?

1 Answer available

Papers discussed in this category

The Journal of allergy and clinical immunology, 2012-02

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

Gut, 2023 Jul 09

Mepolizumab for treatment of adolescents and adults with eosinophilic oesophagitis: a multicentre, randomised, double-blind, placebo-controlled clinical trial.

The New England journal of medicine, 2024 Jun 27

Eosinophil Depletion with Benralizumab for Eosinophilic Esophagitis.

Neurogastroenterology and motility, 2021 Jan

Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0.

The American journal of gastroenterology, 2018-02

Timed Barium Swallow: Diagnostic Role and Predictive Value in Untreated Achalasia, Esophagogastric Junction Outflow Obstruction, and Non-Achalasia Dysphagia.

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