PDF(Pubmed)
Abstract：
UNASSIGNED: Eosinophilic gastritis and eosinophilic duodenitis (EoG/EoD) are often misdiagnosed as functional gastrointestinal (GI) disorders. Consequently, patients with GI symptoms of EoG/EoD may not undergo the necessary steps for diagnosis. We studied gastroenterologists\' evaluations of patients with chronic, unexplained, moderate-to-severe GI symptoms that were unresponsive to over-the-counter medications.
UNASSIGNED: We performed a cross-sectional online survey of 202 board-certified gastroenterologists at office-based practices, community hospitals, or academic institutions. Respondents had been in active clinical practice for 3-35 years post-residency training, spent most of their time on direct patient care, managed ≥1 patient with irritable bowel syndrome and/or functional dyspepsia, and performed ≥1 endoscopy per month. Responses were analyzed to identify barriers to EoG/EoD diagnosis and management.
UNASSIGNED: Respondents managed a mean of 1880 patients per year; the most common diagnoses were functional dyspepsia (36%) and gastroesophageal reflux disease (19%). Mean proportions of patients who underwent upper endoscopy ranged from 42% to 84%. Biopsies were collected from >90% of patients with visible endoscopic mucosal abnormalities vs 42%-72% of patients with normal-appearing mucosae. Approximately 20% of respondents collected only 1-2 biopsies from each site of the GI tract. Only 30% routinely requested pathologists to count eosinophils, and nearly 40% had no histologic threshold for EoG/EoD diagnosis.
UNASSIGNED: Gastroenterologists vary in their evaluation of patients with chronic, unexplained moderate-to-severe GI symptoms. Limited gastric and duodenal biopsy collection, particularly from normal-appearing mucosae, and failure to request tissue eosinophil counts might contribute to underdiagnosis of EoG/EoD. Availability and awareness of EoG/EoD diagnostic guidelines should improve detection in clinical practice.
UNASSIGNED: We performed a cross-sectional online survey of 202 board-certified gastroenterologists at office-based practices, community hospitals, or academic institutions. Respondents had been in active clinical practice for 3-35 years post-residency training, spent most of their time on direct patient care, managed ≥1 patient with irritable bowel syndrome and/or functional dyspepsia, and performed ≥1 endoscopy per month. Responses were analyzed to identify barriers to EoG/EoD diagnosis and management.
UNASSIGNED: Respondents managed a mean of 1880 patients per year; the most common diagnoses were functional dyspepsia (36%) and gastroesophageal reflux disease (19%). Mean proportions of patients who underwent upper endoscopy ranged from 42% to 84%. Biopsies were collected from >90% of patients with visible endoscopic mucosal abnormalities vs 42%-72% of patients with normal-appearing mucosae. Approximately 20% of respondents collected only 1-2 biopsies from each site of the GI tract. Only 30% routinely requested pathologists to count eosinophils, and nearly 40% had no histologic threshold for EoG/EoD diagnosis.
UNASSIGNED: Gastroenterologists vary in their evaluation of patients with chronic, unexplained moderate-to-severe GI symptoms. Limited gastric and duodenal biopsy collection, particularly from normal-appearing mucosae, and failure to request tissue eosinophil counts might contribute to underdiagnosis of EoG/EoD. Availability and awareness of EoG/EoD diagnostic guidelines should improve detection in clinical practice.
摘要：
■嗜酸性粒细胞性胃炎和嗜酸性粒细胞性十二指肠炎（EoG/EoD）通常被误诊为功能性胃肠道（GI）疾病。因此,胃肠道症状为EoG/EoD的患者可能没有接受必要的诊断步骤.我们研究了胃肠病学家对慢性病患者的评估，无法解释,对非处方药无反应的中度至重度胃肠道症状。
■我们在办公室实践中对202名董事会认证的胃肠病学家进行了横断面在线调查，社区医院,或学术机构。受访者已经在积极的临床实践中接受了3-35年的住院医师培训，他们大部分时间都花在直接治疗病人上，管理≥1例肠易激综合征和/或功能性消化不良患者，每月进行≥1次内窥镜检查。分析反应以确定EoG/EoD诊断和管理的障碍。
受访者平均每年管理1880名患者；最常见的诊断是功能性消化不良（36％）和胃食管反流病（19％）。接受上内窥镜检查的患者的平均比例为42％至84％。从>90％的可见内窥镜粘膜异常患者和42％-72％的正常粘膜患者收集活检。大约20％的受访者仅从胃肠道的每个部位收集了1-2次活检。只有30%的人经常要求病理学家计数嗜酸性粒细胞，近40%的EoG/EoD诊断没有组织学阈值。
胃肠病学家对慢性病患者的评估各不相同，不明原因的中度至重度胃肠道症状。有限的胃和十二指肠活检，特别是来自正常的粘膜，未能要求组织嗜酸性粒细胞计数可能导致EoG/EoD的诊断不足。EoG/EoD诊断指南的可用性和认识应提高临床实践中的检测。
■我们在办公室实践中对202名董事会认证的胃肠病学家进行了横断面在线调查，社区医院,或学术机构。受访者已经在积极的临床实践中接受了3-35年的住院医师培训，他们大部分时间都花在直接治疗病人上，管理≥1例肠易激综合征和/或功能性消化不良患者，每月进行≥1次内窥镜检查。分析反应以确定EoG/EoD诊断和管理的障碍。
受访者平均每年管理1880名患者；最常见的诊断是功能性消化不良（36％）和胃食管反流病（19％）。接受上内窥镜检查的患者的平均比例为42％至84％。从>90％的可见内窥镜粘膜异常患者和42％-72％的正常粘膜患者收集活检。大约20％的受访者仅从胃肠道的每个部位收集了1-2次活检。只有30%的人经常要求病理学家计数嗜酸性粒细胞，近40%的EoG/EoD诊断没有组织学阈值。
胃肠病学家对慢性病患者的评估各不相同，不明原因的中度至重度胃肠道症状。有限的胃和十二指肠活检，特别是来自正常的粘膜，未能要求组织嗜酸性粒细胞计数可能导致EoG/EoD的诊断不足。EoG/EoD诊断指南的可用性和认识应提高临床实践中的检测。
