AGA Clinical Update: Best Practices for Diagnosing Immune-Mediated Oesophageal Dysfunction The American Gastroenterological Association (AGA) published an expert review and clinical guidance on oesophageal dysfunction caused by immune-mediated and infectious diseases. The Clinical Gastroenterology and Hepatology update presents 10 best practice advice (BPA) statements and a table outlining key considerations for evaluating patients with oesophageal dysfunction. Introduction Infectious and immune-mediated oesophageal disorders are often underdiagnosed and poorly understood, leading to oesophageal dysfunction and increased healthcare costs due to repeated procedures and limited knowledge of their causes. Without a high index of clinical suspicion, these disorders may go unrecognised. Oesophageal dysfunction can stem from localised infection, immune-mediated disease (e.g., candida), systemic conditions like systemic sclerosis, connective tissue disease, or neurological disorders. In some cases, these conditions contribute to neuromuscular dysfunction and dysmotility. Raising awareness of local and systemic causes of oesophageal dysfunction can improve outcomes by enabling targeted treatment and reducing unnecessary procedures. This AGA review provides BPA on diagnosing immune-mediated disorders in patients with dysphagia, heartburn, and odynophagia. Conclusions It is important for a gastroenterologist to consider immune-mediated and inflammatory diseases when evaluating patients with oesophageal dysfunction, as these conditions are often overlooked. Identifying unusual endoscopic and tissue changes can help in diagnosis. Collaboration with associated disciplines (e.g., rheumatology, dermatology, allergy/immunology, or infectious diseases) improves understanding and treatment. This multidisciplinary approach can help reduce the healthcare burden and improve patient comfort. A thorough patient history and physical exam are essential to detect autoimmune, allergic, or immunosuppressive conditions that may increase the risk of infection and oesophageal disease. Guidance on assessing systemic causes of oesophageal dysfunction remains limited, as do best practices for performing biopsies. However, increasing awareness of these conditions allows gastroenterologists to make better diagnostic decisions and provide more effective care. Amanda Cordell, CEO & Founder, EOS Network Recognising immune-mediated and infectious contributors to oesophageal dysfunction is crucial for refining diagnostic approaches and reducing unnecessary procedures. Among patients on the EOS Network, 80% also have atopic immune-mediated conditions. This highlights the importance of multidisciplinary collaboration and increased awareness in improving patient care and outcomes. There are many clues beyond oesophageal dysfunction, and identifying these broader immune connections can lead to earlier intervention, more personalised treatment strategies, and ultimately better long-term management for patients. Download Could It Be EoE? Signs And Symptoms In collaboration with other patient advocacy groups and Sanofi, we created a resource to raise awareness and improve recognition of these conditions by highlighting their broader signs and symptoms picture. Click the button below to download. Download Read the full publication Reference: Reddy, C. A., McGowan, E., Yadlapati, R., & Peterson, K. (2024). AGA Clinical Practice Update on Esophageal Dysfunction Due to Disordered Immunity and Infection: Expert Review. Clinical Gastroenterology and Hepatology, 22(12), 2378-2387. https://doi.org/10.1016/j.cgh.2024.08.027 Read similar publications: Improving Care in Eosinophil-Associated Diseases: A Charter High Prevalence of GI Disorders in Joint Hypermobility Patients. Study Findings New Clinical Severity Index for Management of EoE Guidelines for Childhood Eosinophilic Gastrointestinal Disorders Beyond EoE by ESPGHAN/NASPGHAN EoE: BSG-BSPGHAN Guidelines (2022) Manage Cookie Preferences