The Emirates Gastroenterology and Hepatology Society Consensus Recommendations for the Diagnosis and Management of Adults with Eosinophilic Esophagitis in the United Arab Emirates: A National Delphi Study

Background: Eosinophilic esophagitis (EoE) is a chronic, immune-mediated esophageal disease characterized by symptoms of esophageal dysfunction and eosinophil-predominant inflammation. Increasing recognition of EoE and advances in its diagnosis and management have highlighted the need for locally relevant, evidence-based guidance for clinical practice in the United Arab Emirates (UAE). Objectives: This study aims to develop practical, evidence-based consensus recommendations for the diagnosis and management of adult EoE tailored to the UAE healthcare setting. Methods: A modified Delphi process was conducted by the Emirates Gastroenterology and Hepatology Society (EGHS). The expert panel consisted of seven nationally recognized EoE specialists, including six gastroenterologists and one histopathologist, representing six healthcare institutions across the UAE. Six key domains were identified: (1) Definition, Pathogenesis, and Epidemiology; (2) Clinical Presentation, Natural History, and Diagnosis; (3) Management and Treatment; (4) Monitoring and Follow-up; (5) Persistent or Refractory EoE; and (6) Emergency Care. Following a comprehensive literature review, consensus statements were developed and evaluated through two rounds of voting. Consensus was predefined as ≥80% agreement, while ≥90% agreement was considered a strong recommendation. Results: Forty-seven consensus statements were developed across the six predefined domains addressing the diagnosis, treatment, monitoring, and management of refractory disease in adult patients with EoE. Conclusions: These consensus recommendations provide a practical, evidence-based framework for the diagnosis and management of adult EoE in the UAE. By integrating current evidence with expert opinion, they aim to standardize clinical practice, support high-quality patient care, and identify priorities for multidisciplinary collaboration and research in EoE across the UAE.