S905 Survey of GI Provider Perspectives of Eosinophilic Esophagitis During Pregnancy

Introduction: Eosinophilic esophagitis (EoE) is a chronic, allergic inflammatory condition of the esophagus, generally resulting in symptoms of dysphagia and food impaction. This disease most commonly affects individuals of reproductive age in their second and third decade of life. Despite its increasing prevalence, there is limited guidance on managing EoE during pregnancy. Methods: We conducted a cross-sectional study using an anonymous online survey given to providers at University of Wisconsin Health Gastroenterology and Hepatology Department. We collected information on provider demographics, comfort in managing EoE during pregnancy, perceived barriers to care, and current practice. Results: Over a 4-week period, we received 46 responses from 72 providers in the department. Participants included gastroenterology attendings (58%), fellows (22%), nurse practitioners (11%), and physician assistants (9%). Participants identified as general gastroenterology practitioners (N = 22), and subspecialists in inflammatory bowel disease (N = 9), hepatology (N = 5), esophagus (N = 3), and other (N = 7). About 80% of providers reported that gastroenterologists should manage EoE during pregnancy due to knowledge of disease pathology, treatment options, and continuity of care. The remaining 20% emphasized the importance of multidisciplinary collaboration, particularly for complex obstetric cases and safe medication use during pregnancy. Only 9% reported feeling adequately trained to provide high-quality care of EoE during pregnancy. Providers expressed the highest comfort with prescribing proton pump inhibitors, and least comfortable initiating dupilumab therapy. Providers were generally neutral about swallowed topical steroids, elimination diets, and endoscopy with dilation. Key barriers to optimal care include lack of established protocols, challenges with patient adherence to medications, limited data on EoE in pregnancy, and concerns about medication safety. Most providers were interested in learning about medication safety during pregnancy, with 69% indicating interest in continuing medical education. Conclusion: While our survey reveals that gastroenterologists should manage EoE during pregnancy, most providers do not feel adequately trained to provide high-quality care in this population. The biggest barrier is the lack of established protocols in this setting. However, there is shared interest among providers in continuing medical education, particularly focused on medication safety in management of EoE during pregnancy.