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