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8. Technical review on the management of eosinophilic esophagitis: a report from the AGA institute and the joint task force on allergy-immunology practice parameters

Author

Rank, Matthew A, Sharaf, Rajiv N, Furuta, Glenn T, Aceves, Seema S, Greenhawt, Matthew, Spergel, Jonathan M, Falck-Ytter, Yngve T, Dellon, Evan S, Institute, AGA, Chachu, Karen A, Day, Lukejohn, Lebwohl, Benjamin, Muniraj, Thiruvengadam, Patel, Amit, Peery, Anne F, Shah, Raj, Singh, Harminder, Singh, Siddharth, Spechler, Stuart J, Sultan, Shahnaz, Su, Grace L, Thrift, Aaron P, Weiss, Jennifer M, Weizman, Adam V, collaborators, Joint Task Force on Allergy-Immunology Practice Parameters, Bernstein, Jonathan A, Dinakar, Chitra, Golden, David BK, Khan, David A, Lieberman, Jay, Oppenheimer, John, Shaker, Marcus, Stukus, David R, Wallace, Dana V, and Wang, Julie

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Food Allergies, Digestive Diseases, Clinical Research, Nutrition, Advisory Committees, Allergens, Allergy and Immunology, Diet, Eosinophilic Esophagitis, Expert Testimony, Glucocorticoids, Humans, Immunotherapy, Interdisciplinary Communication, Practice Guidelines as Topic, Proton Pump Inhibitors, AGA Institute. Electronic address: clinicalpractice@gastro.org, Joint Task Force on Allergy-Immunology Practice Parameters collaborators. Electronic address: drdanawallace@gmail.com, AGA Institute, Joint Task Force on Allergy-Immunology Practice Parameters collaborators, Immunology, Allergy
Abstract

Eosinophilic esophagitis (EoE) is a chronic inflammatory condition of the esophagus. Many new studies have been reported recently that describe EoE management. An expert panel was convened by the American Gastroenterological Association Institute and the Joint Task Force on Allergy-Immunology Practice Parameters to provide a technical review to be used as the basis for an updated clinical guideline. This technical review was developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Eighteen focused EoE management questions were considered, with 15 answered using the GRADE framework and 3 with a narrative summary. There is moderate certainty in the evidence that topical glucocorticosteroids effectively reduce esophageal eosinophil counts to

Published
2020

17. Technical review on the management of eosinophilic esophagitis: a report from the AGA institute and the joint task force on allergy-immunology practice parameters

Author

Chachu, Karen A., Day, Lukejohn, Lebwohl, Benjamin, Muniraj, Thiruvengadam, Patel, Amit, Peery, Anne F., Shah, Raj, Singh, Harminder, Singh, Siddharth, Spechler, Stuart J., Sultan, Shahnaz, Su, Grace L., Thrift, Aaron P., Weiss, Jennifer M., Weizman, Adam V., Bernstein, Jonathan A., Dinakar, Chitra, Golden, David B.K., Khan, David A., Lieberman, Jay, Oppenheimer, John, Shaker, Marcus, Stukus, David R., Wallace, Dana V., Wang, Julie, Rank, Matthew A., Sharaf, Rajiv N., Furuta, Glenn T., Aceves, Seema S., Greenhawt, Matthew, Spergel, Jonathan M., Falck-Ytter, Yngve T., and Dellon, Evan S.

Published
2020
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18. AGA institute and the joint task force on allergy-immunology practice parameters clinical guidelines for the management of eosinophilic esophagitis

Author

Chachu, Karen A., Day, Lukejohn, Lebwohl, Benjamin, Muniraj, Thiruvengadam, Patel, Amit, Peery, Anne F., Shah, Raj, Singh, Harminder, Singh, Siddharth, Spechler, Stuart J., Sultan, Shahnaz, Su, Grace L., Thrift, Aaron P., Weiss, Jennifer M., Weizman, Adam V., Bernstein, Jonathan A., Dinakar, Chitra, Hirano, Ikuo, Falck-Ytter, Yngve T., Rank, Matthew A., Stollman, Neil H., Wang, Kenneth, Stukus, David R., Greenhawt, Matthew, Sharaf, Rajiv N., Chan, Edmond S., Furuta, Glenn, Dellon, Evan, Spergel, Jonathan, Aceves, Seema, Falck-Ytter, Yngve, and Sharaf, Rajiv

Published
2020
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32. Obesity is associated with decreased risk of microscopic colitis in women

Author

Sandler, Robert S, Keku, Temitope O, Woosley, John T, Sandler, Dale P, Galanko, Joseph A, and Peery, Anne F

Subjects
Male, Gastroenterology, General Medicine, Case Control Study, Colitis, Body Mass Index, Colitis, Microscopic, Diarrhea/epidemiology, Risk Factors, Case-Control Studies, Humans, Microscopic/epidemiology, Female, Obesity, Aged
Abstract

BACKGROUND Microscopic colitis is a leading cause of diarrhea in the older adults. There is limited information about risk factors. We hypothesized that obesity would be associated with microscopic colitis. AIM To examine the association between obesity and microscopic colitis in men and women undergoing colonoscopy. METHODS We conducted a case-control study at the University of North Carolina Hospitals. We identified and enrolled men and women referred for elective, outpatient colonoscopy for chronic diarrhea. We excluded patients with a past diagnosis of Crohn’s disease or ulcerative colitis. A research pathologist reviewed biopsies on every patient and classified them as microscopic colitis cases or non-microscopic colitis controls. Patients provided information on body weight, height and exposure to medications via structured interviews or Internet based forms. The analysis included 110 patients with microscopic colitis (cases) and 252 non-microscopic colitis controls. Multivariable analyses were performed using logistic regression to estimate odds ratios and 95% confidence intervals. RESULTS Cases were older and more likely than controls to be white race. Study subjects were well educated, but cases were better educated than controls. Cases with microscopic colitis had lower body mass index than controls and reported more weight loss after the onset of diarrhea. Compared to patients who were normal or under-weight, obese (BMI > 30 kg/m2) patients were substantially less likely to have microscopic colitis after adjusting for age and education, adjusted OR (aOR) 0.35, 95% confidence interval (CI) 0.18-0.66). When stratified by sex, the association was limited to obese women, aOR 0.21, 95%CI: 0.10-0.45. Patients with microscopic colitis were more likely to report weight loss after the onset of diarrhea. After stratifying by weight loss, there remained a strong inverse association between obesity and microscopic colitis, aOR 0.33, 95%CI: 0.10 – 1.11 among the patients who did not lose weight. Ever use of birth control pills was associated with lower risk of microscopic colitis after adjusting for age, education and BMI, aOR 0.38, 95%CI: 0.17-0.84. CONCLUSION Compared to controls also seen for diarrhea, microscopic colitis cases were less likely to be obese. Mechanisms are unknown but could involve hormonal effects of obesity or the gut microbiome.

Published
2022

45. Burden of Gastrointestinal Disease in the United States: 2012 Update

Author

Peery, Anne F., Dellon, Evan S., Lund, Jennifer, Crockett, Seth D., McGowan, Christopher E., Bulsiewicz, William J., Gangarosa, Lisa M., Thiny, Michelle T., Stizenberg, Karyn, Morgan, Douglas R., Ringel, Yehuda, Kim, Hannah P., DiBonaventura, Marco Dacosta, Carroll, Charlotte F., Allen, Jeffery K., Cook, Suzanne F., Sandler, Robert S., Kappelman, Michael D., and Shaheen, Nicholas J.

Published
2012
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