Eosinophilic gastrointestinal disorders (EGIDs) are characterized by higher than normal amounts of a type of white blood cell (eosinophils) in organs that make up the digestive system.
Several types of eosinophilic gastrointestinal disorders exist, including eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis and eosinophilic colitis. Each of the four types of these disorders results in inflammation in and injury to the area of the digestive system it affects — the esophagus, the stomach, the stomach and small intestine, or the large intestine, respectively.
Acid reducers, dietary therapy and steroids are recommended treatments for eosinophilic esophagitis, the most common form of eosinophilic gastrointestinal disorder.
No standard treatments exist for eosinophilic gastritis, eosinophilic gastroenteritis and eosinophilic colitis, although dietary therapy and steroids may be prescribed for these conditions.
Medications that reduce acid production in the stomach (proton pump inhibitors) will often be prescribed as the initial treatment for eosinophilic gastrointestinal disorders.
Many children with eosinophilic esophagitis respond well to dietary therapy, but responses vary among those with other types of eosinophilic gastrointestinal disorders. Expect your child's doctor to recommend a specific diet after taking a detailed medical history and testing your child for food allergies.
- Targeted elimination diets remove all foods that produce a positive result in an allergy test.
- A 6-food elimination diet removes the six most common food allergens — milk, eggs, wheat, soy, nuts and peanuts, and fish and shellfish — regardless of the outcome of an allergy test.
- Elemental diets remove all sources of proteins and replace them with a formula containing amino acids, which are the building blocks of proteins.
After symptoms have disappeared, your child's doctor will recommend that you slowly add foods you've eliminated back into your child's diet, one at a time, to better identify what specific food or foods cause the reaction. The goal is to see how far your child's diet can be expanded again without the recurrence of symptoms.
Corticosteroids such as fluticasone or budesonide, which are meant to be inhaled to treat asthma, are swallowed to help alleviate symptoms in children with eosinophilic esophagitis.
For other types of eosinophilic gastrointestinal disorders and for children who don't respond to these corticosteroids, other corticosteroids, such as prednisone, may be required.
Not all types of eosinophilic gastrointestinal disorders will respond to the same treatment. Talk with your doctor about what type of treatment is most appropriate for your child.
June 17, 2014
- Dellon ES, et al. ACG clinical guideline: Evidenced based approach to the diagnosis and management of esophageal eosinophilia and eosinophilic esophagitis. The American Journal of Gastroenterology. 2013;108:679.
- Treatment of EGIDs. American Partnership for Eosinophilic Disorders. http://www.apfed.org/drupal/drupal/Treatment of EGIDs. Accessed May 21, 2014.
- Alfadda AA, et al. Eosinophilic colitis: An update on pathophysiology and treatment. British Medical Bulletin 2011;100:59.
- What are EGIDs? American Partnership for Eosinophilic Disorders. http://www.apfed.org/drupal/drupal/what_are_egids. Accessed May 21, 2014.