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Dr David R. Stukus on Eosinophilic Esophagitis Guidelines and the Pattern of Disease


David R. Stukus, MD, FACAAI, of Nationwide Children's Hospital and The Ohio State University College of Medicine, and a board member of the American College of Allergy, Asthma & Immunology, discusses guidelines for eosinophilic esophagitis, as well as some disease patterns that may occur.

Guidelines for eosinophilic esophagitis (EoE), which may follow a waxing and waning pattern, were released in 2020, said David R. Stukus, MD, FACAAI, of Nationwide Children's Hospital and The Ohio State University College of Medicine.


Can you discuss the guidelines for EoE, which were presented at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting, and would you describe EoE as a chronic disease?

These guidelines were first published in the spring of 2020, so they've been available for about 18 months now. And these are new guidelines. They actually use something called a grade analysis to ask very specific clinical questions and then they evaluate the body of evidence related to that question, offering both clinical recommendations as well as information about the strength of the evidence. So they're very practical and hopefully useful for people to use. We also know that it can take years before clinical guidelines actually change practice, because people have, you know, limited ability to stay up with the latest and greatest. So that's why this session ['Implementing New Guidelines Into Practice"] is really important, to really help all of our colleagues in allergy and immunology best understand what the guidelines do and don't say, as well as how they can apply that to direct patient care.

EoE often is chronic for both children and adults, but it tends to follow a waxing-waning pattern. So part of what the guidelines address are really long-term management and monitoring. Some people do suffer more of an acute course, and then they improve, whereas others have a long-standing disease.

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