Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, University Hospital Graz, Graz, Austria.
Wien Klin Wochenschr. 2023 Aug;135(15-16):406-413. doi: 10.1007/s00508-023-02198-0. Epub 2023 Apr 18.
Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease of the esophagus with increasing incidence and dysphagia as the main symptom. The management of suspected or known EoE by Austrian endoscopists has not been investigated yet.
A web-based survey with 13 questions about the management of EoE was sent to endoscopists via the Austrian Society of Gastroenterology and Hepatology (ÖGGH).
A total of 222 endoscopists (74% gastroenterologists, 23% surgeons, and 2% pediatricians; 68% working in a hospital) from all 9 states participated. In patients with dysphagia but a normal appearing esophagus, 85% of respondents reported always taking biopsies; however, surgeons were less likely to obtain biopsies compared to gastroenterologists ("always" 69% vs. 90%, "sometimes" 29% vs. 10%, "never" 2% vs. 0%, p < 0.001). The approved budesonide orodispersible tablet is the preferred first-line drug used in EoE, ahead of proton pump inhibitors (PPI). Only 65% of participants monitor the patients by endoscopy and histology after 12 weeks of induction therapy, 26% do not continue maintenance therapy, and 22% monitor patients only when symptomatic.
The vast majority of Austrian endoscopists adhere to the European and US guidelines in cases of suspected EoE. In contrast, despite the chronic disease course, a significant percentage of providers indicate not to use maintenance therapy and monitor the patients routinely.
嗜酸性食管炎（EoE）是一种以食管慢性免疫介导疾病为特征的疾病，其发病率不断增加，吞咽困难是主要症状。奥地利内镜医生对疑似或已知的 EoE 的处理尚未进行调查。
通过奥地利胃肠病学和肝病学学会（ÖGGH），向内镜医生发送了一项关于 EoE 管理的基于网络的调查，其中包含 13 个问题。
共有 222 名内镜医生（74%为胃肠病学家，23%为外科医生，2%为儿科医生；68%在医院工作）参加了这项研究，来自奥地利的 9 个州。在有吞咽困难但食管外观正常的患者中，85%的受访者报告始终进行活检；然而，外科医生比胃肠病医生更不可能进行活检（“总是”为 69%比 90%，“有时”为 29%比 10%，“从不”为 2%比 0%，p<0.001）。在 EoE 中，首选的一线药物是批准的布地奈德口腔崩解片，而不是质子泵抑制剂（PPI）。只有 65%的参与者在诱导治疗 12 周后通过内镜和组织学监测患者，26%的参与者不继续维持治疗，22%的参与者仅在有症状时监测患者。
绝大多数奥地利内镜医生在疑似 EoE 的情况下都遵循欧洲和美国的指南。相比之下，尽管疾病呈慢性过程，但相当一部分提供者表示不使用维持治疗，并且不常规监测患者。
