ToolsCalculators
Eosinophilic Esophagitis Endoscopic Reference Score (EREFS)
Standardised semi-quantitative description of endoscopic findings in eosinophilic esophagitis.
Eosinophilic Esophagitis Endoscopic Reference Score (EREFS)
Edema (loss of vascular markings)
Rings (trachealization/corrugation)
Exudates (white plaques/specks)
Furrows (vertical lines)
Stricture
Result0/8
No inflammatory or fibrostenotic features documented on this exam.
- Edema
- 0
- Rings
- 0
- Exudates
- 0
- Furrows
- 0
- Stricture
- 0
- Composite total
- 0
When to use
- Standardising description of endoscopic findings in eosinophilic esophagitis for diagnosis and for tracking response to treatment over time.
Formula
Sum of 5 endoscopic domains, each graded by severity: Edema 0-1, Rings 0-3, Exudates 0-2, Furrows 0-1, Stricture 0-1 (total range 0-8). The worse of proximal/distal findings is used for each domain.
Pearls and pitfalls
- The 'rings' and 'stricture' domains capture fibrostenotic disease, which is less responsive to anti-inflammatory therapy alone.
- The composite total is a convenience sum; the original system emphasizes reporting each domain individually rather than a single validated cutoff.