1. Eosinophilic Esophagitis
Presented by: Erin Copenhaver, PA-C, CHC

2. Accreditation Information:
The Lowcountry Regional Allergy Update
January 21, 2017
Roper St. Francis Healthcare CME Disclosure Policy:
As a continuing medical education provider, accredited by the South Carolina Medical Association, it is the policy of RSFH to require all individuals in a position to influence educational content and development of a continuing medical education activity to disclose all relationships with commercial interests. This information is disclosed to all activity participants.
The following relationships have been disclosed:
Dr. Ned Rupp, Dr. Patricia Gerber, Dr. John Ramey and Erin Copenhaver have received Grant/Research Support from:
Alcon Pharmaceuticals, Amphaster, Apotex, Astellas, AstraZeneca, Boehringer Ingleheim, Genentech, GlaxoSmithKline, Magna Pharmaceutical, MAP Pharmaceuticals, MedImmune, Merck, Novartis, Sanofi-Aventis, Sepracor (Sunovain), Teva Pharmaceuticals, Vecture, Inflamax, Aimmune, Regeneron, Baxalta.
The following Speaker has nothing to disclose with regards to financial relationships: Dr. Sangeeta Jain
The following Planners: Kara Melin and the CME Committee, Amber Murphy, have nothing to disclose with regards to commercial support.
Target Audience: Physicians and Other Allied Health Professionals
Accreditation Statement:
Roper St. Francis Healthcare designates this live activity for a maximum of 4.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Roper St. Francis is accredited by the South Carolina Medical Association to provide continuing medical education for physicians.
Educational Grant Support:
This activity is supported by an independent educational grant from Shire Immunology, Mylan Inc., Meda, Teva, Sanofi, AstraZeneca, CVS Specialty-Coram and Novartis, Boston Scientific, CSI Behring, Pronetics/Axelacare Infusion
To Receive CME Credit:
Fill out the evaluation and CME Attestation form given to you as part of the handouts. Turn the form in to the registration desk at the end of the meeting. A certificate of credit will be ed to you in 4-6 weeks. If the information on the attestation form is not filled out, a certificate cannot be issued to you. Please print clearly! If you have questions, please call Kara Melin in the CME Office at

3. What is it?
Chronic allergic/inflammatory condition where eosinophils are found in the esophagus

4. Etiology
Delayed hypersensitive reaction to food the patient is consuming
Adverse response to pollen and other airborne allergens that are being swallowed

5. Symptoms
Symptoms can vary by age, may wax and wane making it difficult to diagnose
Intractable reflux
Abdominal pain
Difficulty swallowing
Food impactions
Children often have vomiting, failure to thrive

6. Foods that can be triggers
Any food—may be different for each person
Most common dairy (74%)* and wheat (26%)
Other common triggers: egg (17%), soy (10%), nuts, shellfish
*Wechsler et al Journal Asthma and Allergy 2014

7. Diagnosis Symptoms present Visual evidence on endoscopy
Biopsies of the esophageal tissue on endoscopy pathologically consistent with EoE
Differential Dx of eosinophils in the esophagus: standard GERD, other forms of esophagitis, infection, IBD

8. Determining Triggers Percutaneous skin testing—synthetic or real food
Blood testing for specific IgE to foods
Patch testing—Adults vs children
How effective are each of these?

9. Treatment Elimination of triggers—empiric vs. specific Elemental diets
Medications—corticosteroids, PPI’s
Dilation
New medications

10. Questions?