GuidelineGastroenterology2018
Updated International Consensus Diagnostic Criteria for Eosinophilic Esophagitis: Proceedings of the AGREE Conference.
5 registry-linked trialsOpen access · greenAbstract readConsensus StatementPractice GuidelineReview
In one paragraph
Guideline in Gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 566 papers, 8 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
566citing papers in PubMed, 8 pooled it
97.8field-weighted citation impact, top 1% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Inflammatory Mediators as Potential Non-Invasive Biomarkers and Understanding the Mechanism of Remodeling in Tissue Biopsies in Subjects With Eosinophilic Esophagitis: A Pilot Study
Proton Pump Inhibitor (PPI) Response in Eosinophilic Esophagitis Assessed by Transnasal Endoscopy (TNE)
Eosinophilic Gastrointestinal Disorders Registry
Efficacy of Dupilumab on Facilitated Food Introduction in Eosinophilic Esophagitis
Comparison of Histological Results Obtained From a Mesh Sponge (CytospongeTM) and Traditional Esophageal Mucosal Biopsies in Children and Adolescents With Eosinophilic Esophagitis
Who cites it
566 citing papers in PubMed, 8 syntheses or guidelines pooled it, 1,101 citations in OpenAlex.
- Efficacy of Biological and Steroid Therapies in Adolescent and Adult Patients With Eosinophilic Esophagitis: A Systematic Review and Network Meta-Analysis With Meta-Regression.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026Pooled it
- Effect of budesonide oral suspension on dysphagia and esophageal inflammation in eosinophilic esophagitis: a systematic review and meta-analysis.Frontiers in immunology · 2026Pooled it
- Eosinophilic esophagitis in children and adolescents: a clinical practice guideline.Italian journal of pediatrics · 2025Guideline
- Esophageal and Oropharyngeal Dysphagia: Clinical Recommendations From the United European Gastroenterology and European Society for Neurogastroenterology and Motility.United European gastroenterology journal · 2025Guideline
- BRAZILIAN GASTROENTEROLOGY FEDERATION (FBG) CLINICAL GUIDELINE: DIAGNOSIS AND TREATMENT OF EOSINOPHILIC ESOPHAGITIS IN ADULTS AND ADOLESCENTS.Arquivos de gastroenterologia · 2025Guideline
- Meta-Analysis: Evaluating Placebo Rates Across Outcomes in Eosinophilic Oesophagitis Randomised Controlled Trials.Alimentary pharmacology & therapeutics · 2025Pooled it
- AGA Clinical Practice Update on Esophageal Dysfunction Due to Disordered Immunity and Infection: Expert Review.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024Guideline
- Efficacy of Dietary Therapy for Eosinophilic Esophagitis in Children and Adults: An Updated Systematic Review and Meta-Analysis.Nutrients · 2024Pooled it
- Effect of Budesonide Oral Suspension on Time to First Dysphagia Symptom Response and Dysphagia Symptom Resolution Outcomes in Patients With Eosinophilic Esophagitis.Journal of gastroenterology and hepatology · 2026Trial
- Dupilumab Efficacy in Children With Eosinophilic Esophagitis With Prior Swallowed Topical Corticosteroid Use: A Subgroup Analysis.The American journal of gastroenterology · 2026Trial
- Effect of Food on the Pharmacokinetics, Safety, and Tolerability of Budesonide Oral Suspension in Healthy Adult Participants: A Randomized Phase 1 Study.Journal of clinical pharmacology · 2025Trial
- Clinical Trial: Safety and Efficacy of a Novel Oesophageal Delivery System for Topical Corticosteroids Versus Placebo in the Treatment of Eosinophilic Oesophagitis.Alimentary pharmacology & therapeutics · 2025Trial
- Losartan Treatment Reduces Esophageal Eosinophilic Inflammation in a Subset of Eosinophilic Esophagitis.The journal of allergy and clinical immunology. In practice · 2024Trial
- Dietary composition of adult eosinophilic esophagitis patients is related to disease severity.Immunity, inflammation and disease · 2024Trial
- Article
- Diffuse esophageal eosinophilia is associated with increased endoscopic severity and topical steroid non-response in patients with eosinophilic esophagitis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026Article
- Nasal and inhaled steroid use does not influence treatment response outcomes in eosinophilic esophagitis.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2026Article
- Demographic Differences in Diagnosis of Eosinophilic Esophagitis: A Retrospective Analysis.Laryngoscope investigative otolaryngology · 2026Article
- Dietary Approaches in Eosinophilic Esophagitis.Nutrients · 2026Review
- Efficacy of a Dairy-Free Diet in Adult Patients With Eosinophilic Esophagitis: A Pilot Prospective Multicenter Study.Journal of gastroenterology and hepatology · 2026Article
506 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
66 authors at 20 institutions in 15 countries.
Evan S DellonCenter for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, North Carolina. Electronic address: edellon@med.unc.edu.
Chris A LiacourasCenter for Pediatric Eosinophilic Diseases, Division of Gastroenterology and Hepatology & Nutrition, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Javier Molina-InfanteDepartment of Gastroenterology, Hospital Universitario San Pedro de Alcántara, Cáceres, Spain and Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
Glenn T FurutaDigestive Health Institute, Children's Hospital Colorado, Aurora, Colorado and Gastrointestinal Eosinophilic Diseases Program, University of Colorado School of Medicine, Aurora, Colorado.
Jonathan M SpergelCenter for Pediatric Eosinophilic Diseases, Division of Allergy-Immunology, The Children's Hospital of Philadelphia, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania.
Noam ZevitInstitute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
Stuart J SpechlerCenter for Esophageal Diseases, Baylor University Medical Center and Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas.
Stephen E AttwoodDepartment of Health Services Research, Durham University, Durham, UK.
Alex StraumannSwiss EoE Research Network, Olten, Switzerland.
Seema S AcevesDivision of Allergy, Immunology, Departments of Pediatrics and Medicine, University of California-San Diego and Rady Children's Hospital, San Diego, La Jolla, California.
Jeffrey A AlexanderDivision of Gastroenterology, Mayo Clinic, Rochester, Minnesota.
Dan AtkinsAllergy & Immunology Section, Children's Hospital Colorado and Gastrointestinal Eosinophilic Diseases Program, University of Colorado School of Medicine, Aurora, Colorado.
Nicoleta C ArvaDepartment of Pathology and Laboratory Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Carine BlanchardInstitute of Nutritional Science, Nestlé Research Center, Vevey, Switzerland.
Peter A BonisDivision of Gastroenterology, Tufts University School of Medicine, Boston, Massachusetts.
Wendy M BookAmerican Partnership for Eosinophilic Disorders, Atlanta, Georgia.
Kelley E CapocelliDepartment of Pediatric Pathology, Children's Hospital Colorado, Aurora, Colorado.
Mirna ChehadeMount Sinai Center for Eosinophilic Disorders, Icahn School of Medicine at Mount Sinai, New York, New York.
Edaire ChengDepartments of Pediatrics and Internal Medicine, Children's Medical Center, University of Texas Southwestern Medical Center, Dallas, Texas.
Margaret H CollinsDivision of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Carla M DavisAllergy and Immunology Section of the Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.
Jorge A DiasPediatric Gastroenterology, Centro Hospitalar S. João, Porto, Portugal.
Carlo Di LorenzoDivision of Gastroenterology and Hepatology & Nutrition, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio.
Ranjan DohilDivision of Gastroenterology and Hepatology, University of California-San Diego, Rady Children's Hospital, San Diego, California.
Christophe DupontNecker Hospital, Paris-Descartes University, Paris, France.
Gary W FalkDivision of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Cristina T FerreiraFederal University of Health Sciences of Porto Alegre, Hospital Santo Antônio, Porto Alegre, RS, Brazil.
Adam FoxDepartment of Paediatric Allergy, Guy's & St Thomas' Hospitals NHS Foundation Trust, London, UK.
Nirmala P GonsalvesDivision of Gastroenterology and Hepatology, Northwestern University-Feinberg School of Medicine, Chicago, Illinois.
Sandeep K GuptaDivision of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital of Illinois, University of Illinois, Peoria, Illinois.
David A KatzkaDivision of Gastroenterology, Mayo Clinic, Rochester, Minnesota.
Yoshikazu KinoshitaDepartment of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
Calies Menard-KatcherDigestive Health Institute, Children's Hospital Colorado, Aurora, Colorado and Gastrointestinal Eosinophilic Diseases Program, University of Colorado School of Medicine, Aurora, Colorado.
Ellyn KodroffCampaign Urging Research for Eosinophilic Diseases, Lincolnshire, Illinois.
David C MetzDivision of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Stephan MiehlkeCentre for Digestive Diseases, Internal Medicine Center, Eppendorf, Hamburg, Germany.
Amanda B MuirCenter for Pediatric Eosinophilic Diseases, Division of Gastroenterology and Hepatology & Nutrition, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Vincent A MukkadaDivision of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Simon MurchDepartment of Paediatrics, University Hospital Coventry & Warwickshire, Coventry, UK.
Samuel NurkoCenter for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Boston, Massachusetts.
Yoshikazu OhtsukaDepartment of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Rok OrelUniversity of Ljubljana, Faculty of Medicine, University Children's Hospital, Ljubljana, Slovenia.
Alexandra PapadopoulouDivision of Gastroenterology and Hepatology, First Department of Pediatrics, University of Athens, Children's Hospital Agia Sofia, Athens, Greece.
Kathryn A PetersonUniversity of Utah, Salt Lake City, Utah.
Hamish PhilpottNorthern Adelaide Local Health Network, Department of Gastroenterology, University of Adelaide, South Australia.
Philip E PutnamDivision of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Joel E RichterUniversity of South Florida Morsani College of Medicine, Tampa, Florida.
Rachel RosenAerodigestive Center, Boston Children's Hospital, Boston, Massachusetts.
Marc E RothenbergDivision of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Alain SchoepferDivision of Gastroenterology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
Melissa M ScottEosinophilic Family Coalition, Cincinnati, Ohio.
Neil ShahDepartment of Paediatric Gastroenterology, Great Ormond Street Hospital, London, UK.
Javed SheikhKaiser Permanente Los Angeles Medical Center, Los Angeles, California.
Rhonda F SouzaCenter for Esophageal Diseases, Baylor University Medical Center and Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas.
Mary J StrobelAmerican Partnership for Eosinophilic Disorders, Atlanta, Georgia.
Nicholas J TalleyFaculty of Health and Medicine, University of Newcastle, Australia.
Michael F VaeziDivision of Gastroenterology, Hepatology and Nutrition, Vanderbilt University School of Medicine, Nashville, Tennessee.
Yvan VandenplasKidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Mario C VieiraDepartment of Pediatrics, Pontifical University of Paraná and Center for Pediatric Gastroenterology, Hospital Pequeno Príncipe, Curitiba, Brazil.
Marjorie M WalkerAnatomical Pathology University of Newcastle Faculty of Health and Medicine School of Medicine and Public Health Callaghan, New South Wales, Australia.
Joshua B WechslerEosinophilic Gastrointestinal Diseases Program, Division of Gastroenterology, Hepatology, and Nutrition, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
Barry K WershilEosinophilic Gastrointestinal Diseases Program, Division of Gastroenterology, Hepatology, and Nutrition, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
Ting WenDivision of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Guang-Yu YangDepartment of Pathology, Northwestern University-Feinberg School of Medicine, Chicago, Illinois.
Ikuo HiranoDivision of Gastroenterology and Hepatology, Northwestern University-Feinberg School of Medicine, Chicago, Illinois.
Albert J BredenoordDepartment of Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands.
Cincinnati Children's Hospital Medical Center · USChildren's Hospital Colorado · USNorthwestern University · USChildren's Hospital of Philadelphia · USAmerican Partnership for Eosinophilic Disorders · USBaylor University Medical Center · USBoston Children's Hospital · USLurie Children's Hospital · USMayo Clinic · USUniversity of California San Diego · USUniversity of Newcastle Australia · AUUniversity of Pennsylvania · USAmsterdam UMC Location University of Amsterdam · NLBaylor College of Medicine · USCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas · ESChildren's Hospital of Illinois · USChildren's Medical Center · USDélégation Paris 5 · FRDurham University · GBEppendorf (Germany) · DE
Funding
UNC-CH CENTER FOR ENVIRONMENTAL HEALTH &SUSCEPTIBILITYP30ES010126 · NIEHS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Stephanie Engel · 2001 to 2026
$36.3MTRAINING (CAREER DEVELOPMENT) COMPONENTU54AI117804 · NIAID · CINCINNATI CHILDRENS HOSP MED CTR · PI GLENN T FURUTA, Marc E. Rothenberg · 2014 to 2026
$18.5MPatient research in eosinophilic gastrointestinal diseasesK24DK100303 · NIDDK · UNIVERSITY OF COLORADO DENVER · PI FURUTA, GLENN T · 2013 to 2017
$889kNIAID NIH HHS U54 AI117804NIDDK NIH HHS K24 DK100303NIEHS NIH HHS P30 ES010126
Abstract
BACKGROUND &
aimsOver the last decade, clinical experiences and research studies raised concerns regarding use of proton pump inhibitors (PPIs) as part of the diagnostic strategy for eosinophilic esophagitis (EoE). We aimed to clarify the use of PPIs in the evaluation and treatment of children and adults with suspected EoE to develop updated international consensus criteria for EoE diagnosis.
methodsA consensus conference was convened to address the issue of PPI use for esophageal eosinophilia using a process consistent with standards described in the Appraisal of Guidelines for Research and Evaluation II. Pediatric and adult physicians and researchers from gastroenterology, allergy, and pathology subspecialties representing 14 countries used online communications, teleconferences, and a face-to-face meeting to review the literature and clinical experiences.
resultsSubstantial evidence documented that PPIs reduce esophageal eosinophilia in children, adolescents, and adults, with several mechanisms potentially explaining the treatment effect. Based on these findings, an updated diagnostic algorithm for EoE was developed, with removal of the PPI trial requirement.
conclusionsEoE should be diagnosed when there are symptoms of esophageal dysfunction and at least 15 eosinophils per high-power field (or approximately 60 eosinophils per mm
Indexed as
AlgorithmsConsensusDiagnostic Techniques, Digestive SystemEosinophilic EsophagitisGastroenterologyHumansPredictive Value of TestsPrognosisProton Pump InhibitorsProton Pump InhibitorsDiagnosisEosinophilic EsophagitisEsophageal EosinophiliaProton Pump Inhibitor
Identifiers
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Registered trials
NCT03822325ClinicalTrials.gov
NCT04149470ClinicalTrials.gov
NCT05199532ClinicalTrials.gov
NCT05247866ClinicalTrials.gov
NCT05342168ClinicalTrials.gov
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.