title: Diagnostic and therapeutic management of eosinophilic oesophagitis in children and adults: results from a Spanish registry of clinical practice.
abstract: BACKGROUND
  Eosinophilic oesophagitis has emerged as a common cause of oesophageal symptoms.
  
  
  OBJECTIVE
  To document practice variation in care provided to eosinophilic oesophagitis patients in Spain and to assess adherence to available guidelines.
  
  
  METHODS
  A prospective survey-based registry including data from all patients receiving care from gastroenterologists and allergists throughout Spain was developed.
  
  
  RESULTS
  Data from 705 patients (82% adults, male:female ratio 4.1:1) were collected from 26 Spanish hospitals. 42.7% received care in teaching hospitals. Adults presented dysphagia and food impaction more frequently; vomiting and weight loss predominated in children (p < 0.01). A mean diagnostic delay of 54.7 and 28.04 months was documented for adults and children, respectively. Normal endoscopic exams were reported in 27.6% and directly related to the experience in managing the disease (p < 0.05). Paediatric patients, non-teaching hospitals and greater experience in managing eosinophilic oesophagitis were associated with increased frequency in eosinophil count reports and with taking gastric and duodenal biopsies (p < 0.001). Initial therapy consisted of topical steroids (61.7% of patients), proton pump inhibitors (52.4%), dietary modifications (51.26%) and endoscopic dilation (7.2%). Referrals to allergy units occurred more frequently in teaching hospitals (p = 0.003) where food restrictions generally followed allergy test results (p < 0.001).
  
  
  CONCLUSIONS
  Availability of facilities and the physician's experience constituted the most important factors in explaining differences in patient management.
authors: Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Ciudad Real, Spain. alucendo@vodafone.es
authors: Alfredo J
authors: AJ
authors: Lucendo
authors: Ángel
authors: Á
authors: Arias
authors: Javier
authors: J
authors: Molina-Infante
authors: Joaquín
authors: J
authors: Rodríguez-Sánchez
authors: Luis
authors: L
authors: Rodrigo
authors: Óscar
authors: Ó
authors: Nantes
authors: Elena
authors: E
authors: Pérez-Arellano
authors: Susana
authors: S
authors: de la Riva
authors: Ángeles
authors: Á
authors: Pérez-Aisa
authors: Jesús
authors: J
authors: Barrio
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000486:Allergy and Immunology / Q000592:standards; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D004035:Diet Therapy; D004106:Dilatation; D057765:Eosinophilic Esophagitis / Q000175:diagnosis* / Q000628:therapy; D050782:Esophageal pH Monitoring; D004945:Esophagoscopy; D005260:Female; D005762:Gastroenterology / Q000592:standards; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012042:Registries; D013030:Spain; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D054328:Proton Pump Inhibitors