Mayo ClinicTransnasal Endoscopy Offers Sedative-free Alternative

Bridging Innovations in Eosinophilic Esophagitis: From Diagnosis to Management

Eosinophilic esophagitis (EoE) represents a chronic immune-mediated condition characterized by eosinophilic infiltration of the esophagus, leading to tissue damage and a spectrum of clinical symptoms. Mayo Clinic Children’s Center is at the forefront of distinguishing EoE from similar gastrointestinal disorders, offering state-of-the-art diagnostic and therapeutic approaches. This article highlights the center’s multidisciplinary approach, innovative diagnostic techniques like transnasal endoscopy, and ongoing research into artificial intelligence for disease characterization and treatment prediction. Through comprehensive evaluation and individualized management plans, the clinic exemplifies the integration of advanced technology and research into patient care, setting a new standard in EoE treatment.

Key Points:

• Eosinophilic esophagitis (EoE) is a chronic immune system disease, characterized by eosinophil accumulation in the esophagus, leading to inflammation or injury.
• Symptoms in children include difficulty eating, vomiting, abdominal pain, dysphagia, impaction, and failure to thrive.
• Mayo Clinic Children’s Center excels in differentiating EoE from GERD and other conditions with similar symptoms, diagnosing and treating nearly 1,500 patients annually.
• A multidisciplinary clinic approach is employed, involving pediatric gastroenterologists, allergist-immunologists, and dietitians for a thorough and individualized management plan.
• Transnasal endoscopy (TNE), an innovative, less invasive diagnostic procedure, is offered, allowing awake procedures without the need for sedation or anesthesia, facilitating more frequent assessments.
• Eligibility for TNE includes being 5 years or older, having no relevant anatomic abnormalities, and being cooperative during examinations.
• Mayo Clinic is pioneering research in artificial intelligence to identify histologic markers for EoE, enhancing diagnosis accuracy and treatment efficacy.
• The AI model developed for EoE demonstrates excellent performance in identifying, quantifying, and scoring histopathologic features, offering a reproducible method for semi-automated analysis of esophageal biopsies.
• Eosinophil-derived neurotoxin (EDN) levels in esophageal epithelial samples may predict proton pump inhibitor responsiveness, highlighting a potential biomarker for treatment efficacy.

The prevalence of eosinophilic esophagitis has been rising globally, with studies indicating a current estimate of approximately 57 cases per 100,000 people.

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