Eosinophilic Esophagitis (EoE) is a chronic disease of the esophagus that in recent years has become a very prevalent cause of esophageal symptoms in children, adolescents and adults. First characterized as a distinct disorder less than 30 years ago, EoE now represents the most prevalent form of eosinophilic enteropathy, and the second leading cause of chronic esophagitis overall, after gastroesophageal reflux disease.

However, EoE is still an underdiagnosed entity in many settings, and a significant diagnostic delay has been described for patients suffering from it. EoE generates in patients a marked deterioration in health-related quality of life and its care represents significant costs for health systems. For this reason, it is necessary to raise awareness about this disorder among health professionals from different disciplines, specialties and care levels (primary health care and specialized care).

This online course explains current knowledge about the epidemiology and etiology of EoE, methods for its diagnosis, and therapeutic alternatives. In addition, it presents the lines of research in progress on future therapies and highlights the areas of research that are still pending.

This course, promoted by EUREOS (European Consortium for Eosinophilic Diseases of the Gastrointestinal Tract) has various authors and speakers from various disciplines, all of them recognized international experts in EoE research.

This course is suitable for gastroenterologists, paediatricians, allergists, ENT specialists, and specialists working in digestive endoscopy, regardless of their familiarity with EoE. In addition, the course is aimed at primary care family doctors and paediatricians, as well as nurses, dieticians and nutritionists, and researchers interested in this disease.

Likewise, gastroenterologists, allergists and pediatricians in training are welcome, as well as medical students in advanced years interested in these specialties.

EACMME certificates will be provided after having passed the course and a corresponding online exam.

• • The course is completely free for all participants, after registering via the course platform.
  • Professionals who complete the course will be eligible for CME credits granted by the EACCME, after passing a multiple choice exam for each module (two attempts are possible).
  • This course is fully funded by EUREOS and the industry partners that support this society. Its content is completely free and independent of commercial interests.

General objective

To update knowledge about eosinophilic esophagitis, including its epidemiological, diagnostic and therapeutic aspects, with a multidisciplinary approach, and based on the most up-to-date scientific evidence and best clinical practice.

Specific objectives

1. To know the current epidemiological characteristics of eosinophilic esophagitis, including its incidence and prevalence and temporal trends, globally and in European environments. Defining the current risk factors identified for the development of the disease, and to understand the pathophysiological bases by which they interact with the mucosal-associated immune system to generate the disease.
2. To recognize the forms of clinical presentation of the disease throughout the different ages of life.
3. To know the role that endoscopy plays in the diagnostic process of eosinophilic esophagitis, and learn to identify the main endoscopic findings in these patients, as well as their accuracy in reaching the diagnosis of the disease.
4. To learn the most appropriate procedure for taking esophageal biopsies in eosinophilic esophagitis, including their number and location to obtain maximum diagnostic yield. To recognize the main histopathological findings associated with eosinophilic esophagitis.
5. To expose the associations described between eosinophilic esophagitis and different atopic manifestations. To define the role of food allergy testing in the diagnostic and therapeutic process of patients with eosinophilic esophagitis.
6. To define the current treatment goals for eosinophilic esophagitis, according to the evolving characteristics of the disease and its natural history.
7. To know the efficacy (in terms of its ability to improve symptoms and restore histology) and safety of proton pump inhibitor therapy in children and adults with eosinophilic esophagitis. To define the doses to be used to in the short- and long-term management of patients responding to this therapy.
8. To know the efficacy (in improving symptoms and restoring histology) and safety of swallowed topical steroid treatment in children and adults with eosinophilic oesophagitis. To present the short-term and long-term results of trials with these drugs. Discuss the differences between drugs, the doses to be used and the differences in their presentations according to patient profiles.
9. Knowing the different alternatives based on the use of diets for the treatment of children and adults with eosinophilic esophagitis. Present the different dietary approaches and their expected efficacy. Provide practical advice for the implementation of dietary treatment in clinical practice.
10. To provide updated knowledge on the efficacy and safety of endoscopy dilation in the treatment of patients with eosinophilic esophagitis, throughout different ages. To recognize the indications of the technique and discuss the advantages of the different dilation devices.
11. Present the treatment algorithm for eosinophilic esophagitis proposed in the new evidence-based guidelines for the comprehensive management of this disease, defining the choice of therapy according to specific patient profiles.
12. To present and discuss the different areas of uncertainty in the diagnosis and therapy of EoE, and to acknowledge potential areas for future research.

1. Eosinophilic esophagitis: concept and epidemiology

1.1. Historical background and current concept of EoE (Stephen Attwood)

1.2. Epidemiology of EoE, current figures and temporal trends (Danila Guagnozzi)

1.3. Risk factors for EoE: genes vs. environment (Marc Rothenberg)

1.4. Atopy in EoE (Antonella Cianferoni)

2. Diagnosis of EoE

2.1. When to suspect EoE? A view of symptoms throughout the ages (Salvatore Oliva)

2.2. Endoscopic features in EoE and biopsy procedure (Christoph Schlag)

2.3. Histology in EoE: more than eosinophils (Michael Vieth)

2.4. Non-invasive markers in EoE (Martina Votto)

3. Therapeutic approach to EoE

3.1. Treatment outcomes in EoE: an evolving concept (Alex Straumann)

3.2. Dietary treatment for EoE: targeting the cause (Javier Molina-Infante)

3.3. PPI therapy in EoE: beyond acid suppression (Alfredo J Lucendo)

3.4. Topic steroid therapy in EoE: ever better formulations (Stephan Miehlke)

3.5. Endoscopic therapy in EoE (Matteo Ghisa)

3.6. A glimpse to the future: biological drugs and novel small molecules (Albert J Bredenoord)

4. Long term management of EoE

4.1. Long-term monitoring of patients with EoE (Ulrike von Arnim)

4.2. Maintenance treatment of EoE in the long-term. How do we do it? (Alain Schoepfer)

4.3. EoE after 30 years: still a lot to know (Alfredo J Lucendo)