Eosinophilic Gastrointestinal Disorders

Eosinophilic gastrointestinal disorders (EGIDs) are chronic, inflammatory diseases characterized by an elevated number of eosinophils in one or more areas of the digestive system.

Eosinophils are a type of white blood cell that are part of the body’s immune system. Eosinophils have many roles in the body’s immune response, especially in allergic disorders. Eosinophils also help fight infections from bacteria and parasites. Increased numbers of eosinophils in the digestive tract, also called eosinophilic inflammation, can occur if the normal immune function of the digestive tract becomes dysregulated.

EGID Types

  • Eosinophilic Esophagitis (EoE) – Increased number of eosinophils in the esophagus (at least 15 per high power field) and the most common of the EGIDs
  • Eosinophilic Gastritis (EoG) – Increased number of eosinophils in the stomach (at least 30 per high power field in at least 3-5 fields)
  • Eosinophilic Duodenitis (EoD) – Increased number of eosinophils in the duodenum (at least 50 per high power field in at least 3 fields)
  • Eosinophilic Enteritis (EoN) - Increased number of eosinophils in the small intestine
  • Eosinophilic Colitis (EoC) – Increased number of eosinophils in the colon

What Are the Symptoms of Eosinophilic Gastrointestinal Disorders?

The symptoms of an EGID vary widely and depend on the affected area of the digestive tract. Symptoms include:

  • Abdominal pain
  • Nausea
  • Vomiting
  • Poor appetite
  • Poor weight gain
  • Feeding aversion
  • Diarrhea

Older children can experience symptoms of difficulty swallowing, or food can become stuck in the esophagus, which is also known as a food impaction.

How Are Eosinophilic Gastrointestinal Disorders Diagnosed?

Currently, the only way to confirm the diagnosis of an EGID is by having an endoscopy/colonoscopy with biopsies. Biopsies are small pieces of tissue that are taken and reviewed under the microscope by a pathologist. During an endoscopy, a flexible tube with a camera is inserted through the mouth to allow the gastroenterologist to look inside the esophagus, stomach, and duodenum (first part of the small intestine).

A colonoscopy is similar to an endoscopy, but the tube is inserted through the anus and looks inside the rectum, colon, and ileum (part of the small intestine).

The visual appearance of eosinophilic esophagitis is often seen in features such as those shown here.

Granular

White Exude

Rings

Furrowing

Treatment

Treatment consists of food elimination, elemental diet or medications. Typically, an endoscopy with biopsies is repeated eight to twelve weeks after being treated to establish that the treatment was effective and the disease is in remission. Learn more about food elimination diets.