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Conferences and Medical Updates

DDW update 2016

                i.         EoE : Rate of EoE is increasing.  Oral budesonide suspension is effective in maintaining remission upto 24 weeks.  Dose was 2 mg twice a day.

              ii.         EoE : After treatment with topical steroids for 8 weeks – response was durable.  University of NC study.

             iii.         High dose fluticasone is 880 mcg or budesonide 2000 mcg per day.

             iv.         Dietary intervention for EoE, – amino acid based diet decreases EoE by 70%.  ( use neocate infant formula or nutrica) and use for 4 weeks.

              v.         EoE be very careful in dilataion.

            vi.         EoE – histologic non responders, topical steroids for longer duration does not improve response

           vii.         Lower dose of steroid have a higher relapse rate.

         viii.         Relapse rate of topical steroids is high (histologic)

            ix.         Flexible endoscopic zenkers diverticulotomy works (EZD) works

              x.         Endoscopic zenkers diverticulotomy using a sealing device and diveruloscopy works  Ligasure is the device in Spain

            xi.         Risk factors for dysplasia or turning to barretts and then to dysplasia to cancer : White obese males – do 8 bx at GE junction..  Consider RFA if long segment BE.

           xii.         BE nodules – if more than 2 mm BX it.  Nodularity also associated with higher chance of dysplasia.

         xiii.         Residual metaplasia after RFA – continue survellience.

         xiv.         Hp vaccination