Amanda Muir (Muir Lab)

@RSanchez490MD @PedsGIChat @dr_rdvenkatesh I use it to find the narrowest point as well as to help me decide which balloon size to use at the beginning of the dilation. Thanks for the question! #EndoFLIP

@dr_rdvenkatesh Is there a role in esophageal #dilation in patients with persistent dysphagia without an identified scar tissue and endoscopic &mucosal healing?

@PedsGIChat @dr_rdvenkatesh @pedsgidoctora There are times where we will do a slow introduction of milk, beginning with baked and then starting regular milk. This may helps kids have a less restrictive diet if restricted.

@dr_rdvenkatesh @dr_rdvenkatesh, @pedsgidoctora askeed: Can you please comment on restriction of fresh dairy only as opposed to fresh and baked dairy when restricting dairy for EoE?

@dr_rdvenkatesh When do you consider dietary therapy such as 4FED or Elemental therapy in a patient with #EoE?

@PedsGIChat There are studies trying to identify #biomarkers, less invasive ways of monitoring disease, trials to figure out the exact food. There are also several biologics in development. The esophageal string test is a non-invasive way to gather esophageal secretions and detect EoE.

What does the future of #EoE therapy look like? Are there any studies on identifying the allergen-causing EoE and desensitization?

@MohammadDwi33 @PedsGIChat @bowelsounds @dr_rdvenkatesh Great question! That would be a good study. Because diagnosis relies on endoscopy, access to pediatric gastroenterologist can be an obstacle.

@PedsGIChat @bowelsounds @LabMuir @dr_rdvenkatesh Do you think EoE is underdiagnosed in medicine and specially in low-income countries? can lowering the threshold for endoscopies help in diagnosis? thanks for the event!

Welcome to another #PEDSGIChat. Collaboration with @bowelsounds and #NASPGHANToday, we will discuss managment of Eosinophilic Esophagitis #EoE with Dr. Amanda Muir @LabMuir and Dr. Rajitha Venkatesh @dr_rdvenkatesh If you have ❓or comments, join in.

@PedsGIChat Check this out: pubmed.ncbi.nlm.nih.gov/36000828/

@PedsGIChat There is evidence that aeroallergens cause esophageal eosinophilia. Aeroallergens may cause EoE exacerbations and patients may need management of rhinitis during certain seasons. It is likely a rare entity that remains mostly discussed in case reports.

What does the literature say about aeroallergens leading to the worsening of #EoE symptoms &scope findings?

@PedsGIChat It allows the physician to monitor diameter and distensibility overtime and assess for subtle narrowing that may not be picked up by regular endoscopy.

@LabMuir 2️⃣What is the role of Endoflip in diagnosing and managing #EoE?

@dr_rdvenkatesh 1️⃣Do patients with EoE develop #esophageal dysfunction from #fibrosis or #dysmotility?

@PedsGIChat Its nice to start with #PPI as it is safe and effective and can get about 40% of kids into remission.

🚨How would you treat❓ 12yo w/Abd pain😫& #dysphagia &⬇wt. ✅ Esophagram NL &Scope➡️ #EoE (50 eos/HPF). How would you treat before repeating scoping in 2-3 months?

@PedsGIChat annallergy.org/article/S1081-… This expert guideline shares some clinical scenarios where #dupilumab should be considered.

@LabMuir 1️⃣What are the criteria for starting #Dupilumab in #peds #patients with #EoE?

@PedsGIChat It has been nearly a year since its official @US_FDA approval for EoE, however, there are no defined criteria carved out in the literature yet. It should be considered for those patients with multiple comorbid atopic conditions, refractory to current therapy, poor compliance

@RSanchez490MD @PedsGIChat @dr_rdvenkatesh Fungal esophagitis can occur in a small number of patients but is treatable (<10%). And in kids who are on many topical steroids (inhaled/topical) it is good to keep an eye on AM cortisol

@dr_rdvenkatesh 1️⃣ What are the pros/cons of using #Fluticasone vs. #Budesonide (Pulmicort) to treat patients with #EoE?

@PedsGIChat If in mucosal remission, could attempt to wean to half dose and then rescope in 12-16 weeks. If discontinuing, would recommend pivoting to another treatment.

@LabMuir 2️⃣When would you consider weaning or discontinuing swallowed #steroids?

@PedsGIChat Based on a repeat endoscopy, if an #EoE patient does not have mucosal improvement, would recommend discontinuation of a #PPI. Or potentially attempting to wean once a patient has achieved mucosal remission.

Dr. @LabMuir 2️⃣ would you consider weaning or discontinuing #PPI?

When treating an #EoE patient with #PPI only @dr_rdvenkatesh 1️⃣ is there a standard dose to start?

@PedsGIChat @ChildrensPhila @nationwidekids @NASPGHAN Thank you so much for having me! Excited to talk about #EoE

✅Dr. Amand Muir is a #peds #Gastro and #EoE specialist @ChildrensPhila & head of the @Labmuir studying esophageal fibrosis ✅Dr. Rajitha Venkatesh is a #Peds #Gastro & #EoE specialist @nationwidekids and Chair of the @NASPGHAN #EGID #SIG Thank you both for joining 🙏🏽

🚨New #peds #GITwitter Chat 💻Join the 💬 this #Thursday as we dive into the management of #EoE with Dr. Muir &Dr Venkatesh #MedTwitter @NMGastro ⁩⁦@NMEsophagi⁩ @CharityEos @EosinophilicC @EosinophilSoc @eosinophils @curedfoundation @LabMuir @dr_rdvenkatesh @temarahajjat

🎙New Episode Alert 🚨 ➡️Dr. Amanda Muir talks Tx of #EoE w/Drs. @temarahajjat & @PLLU ✅PPI? Steroids? Dietary therapy? Dupilumab? ✅#Endoflip 🎧Tune in to learn about the latest Tx insights @LabMuir @ChildrensPhila @eosinophils ⁦@NMEsophagi⁩ @CharityEos @EosinophilicC

Congrats to @lab_hill on his stellar talk on the role of T cells in EGIDs at @AAAAI_org. #eoe #egid

Last week we were able to honor the amazing work Dr. Jonathan Spergel has done at @ChildrensPhila at our inaugural Honor Your Doctor event. Thanks to all the doctors across the country who make a positive impact on families with #foodallergies.

Thank you to the division of GI at Robert Wood Johnson for inviting me to speak about #eoe my alma mater #rwjms

Had a wonderful time discussing fibrosis in #EoE with the Inflammation and Immunity folks at ClevClinic. Big thanks to @IBD_FloMD