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Management of Eosinophilic Esophagitis

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Key Points ➤ Eosinophilic esophagitis (EoE) was first characterized in the early 1990s and understood to be a food antigen-driven Th2 inflammatory condition. ➤ A large body of evidence suggests that EoE subjects have aeroallergen sensitization and concurrent atopic diseases including asthma, allergic rhinitis and eczema. • There is a close interaction between these organ-specific diseases and a potential for common triggering antigens in EoE and other atopic conditions. GRADE Strength of Recommendations and Implications Grade Quality of Evidence High We are very confident that the true effect lies close to that of the estimate of the effect. Moderate We are moderately confident in the effect estimate. e true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low Our confidence in the effect estimate is limited. e true effect may be substantially different from the estimate of the effect. Very low We have very little confidence in the effect estimate. e true effect is likely to be substantially different from the estimate of effect. Knowledge Gap May vary depending upon the severity of initial clinical presentation. Grade Strength of Recommendation For the Patient For the Clinician Strong Most individuals in this situation would want the recommended course of action, and only a small proportion would not. Most individuals should receive the recommended course of action. Formal decision aids are not likely to help individuals make decisions consistent with their values and preferences. Conditional e majority of individuals in this situation would want the suggested course of action, but many would not. Different choices will be appropriate for different patients. Decision aids may be useful in helping individuals in making decisions consistent with their values and preferences. Clinicians should expect to spend more time with patients when working towards a decision. No recommendation The confidence in the effect estimate is so low that any recommendation is speculative at this time.

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