403 International Survey on Evaluation and Management of Eosinophilic Esophagitis

BACKGROUND: The criteria for diagnosis of Eosinophilic Esophagitis (EoE) have been established; however the recommendations regarding evaluation and management of patients have been debated. The purpose of this survey study is to assess how providers across the world diagnose, evaluate and treat patients with EoE and how education impacts their approach. METHODS: The link to a web-based survey was sent to the members of WAO, ACAAI and AAAAI. From October 2010 to January 2011, the participants were asked to respond to 24 questions. The qui-square test was used for comparison between groups which included: practitioners from the Unites States versus other countries, male versus female, different specialties, years in practice, academic versus private, rural versus suburban, number and frequency of patients, number of lectures and workshops the practitioners attend. RESULTS: Among the 200 respondents, 70% were from the United States. Majority of respondents were allergists/allergolosits. The majority responded that biopsy is required to diagnose EoE, that they do ask about personal and family history of atopy and they do recommend allergy evaluation via testing; these were similar between all groups. When comparisons were made between the groups, these areas showed statistically significant differences: 1) Practitioners who see more patients with EoE more frequently were more likely to perform testing for immediate hypersensitivities to aeroallergens and foods. 2) Practitioners who participate more often in workshops were less likely to perfrom patch testing for foods. CONCLUSIONS: Our survey reveals that allergy practitioners worldwide are following patients with EoE. Practitioners who see more patients with EoE more frequently are more likely to perform allergy testing in form of hypersensitivity testing to both aeroallergens and foods. This could be secondary to participation in educational sessions or more interest in searching the literature. Participation in workshops has an inverse relation to performing patch testing for foods, which may show that current education does not support this practice. In order to have a more uniform approach to patients with EoE, a consensus guideline is prudential.