Eosinophilic GI Disorders

A growing number of children and adults suffer from Eosinophilic (ee-oh-sin-oh-fill-ick) Gastrointestinal Disorders (EGID).  Eosinophilic disorders are characterized by having above normal amounts of eosinophils (a type of white blood cell) in one or more specific places in the digestive system.   The diagnosis typically indicates the organ(s) involved:

 

• Eosinophilic esophagitis – (also known as “EoE”) indicates that the esophagus is involved
• Eosinophilic gastritis –the stomach is involved
• Eosinophilic gastroenteritis - stomach and small intestine are involved
• Eosinophilic colitis – the large intestine is involved

Eosinophilic disorders can mimic the symptoms of many other diseases including inflammatory bowel disease, food allergies, irritable bowel syndrome and reflux.

 

Symptoms may include:

• Nausea or Vomiting
• Diarrhea
• Failure to thrive (poor growth or weight loss)
• Abdominal or chest pain
• Reflux that does not respond to usual therapy
• Anorexia (poor appetite)
• Bloating
• Anemia
• Blood in the stool
• Malnutrition

Diagnosis

 

The first step is an EGD (esophagogastroduodenoscopy) along with biopsies (taking small samples of tissue), this is done by a gastroenterologist. 

 

Allergy testing should be the next step in the treatment.  There are two types of testing that must be performed, skin prick testing and Atopic patch testing (click here for more information on testing). It is important to do both skin testing and patch testing to identify all the potential allergens. (blood testing seems to be much less effective at identifying food allergens than the skin prick testing.)

 

Skin prick testing alone will not identify  approximately 1/3 of the possible food allergens.

 

At this time there is no other diagnostic test that can replace atopic patch testing.

 

 

Treatment

 

Identification and elimination of the suspected foods will improve 77% of all patients. Many of the remaining 25% fail due to missing a food allergen during testing or poor compliance with elimination of identified food allergens from diet

 

Steroids may be needed in other patients, but should be second line for patients who are failing food elimination therapy.

 

 

 

There is no "cure," studies have shown that only approximately 5% develop tolerance to the food allergies years downs the road. Treatment can help alleviate symptoms and prevent further damage to the gastrointestinal tract.   Dr. Mayer has experience treating eosinophilic disorders and can discuss the various treatment options.  Dr. Mayer’s goal is to work with the patient to find a therapy that is best for you and your family.