Pediatric Eosinophilic Gastrointestinal Diseases (EGIDs)

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Pediatric Gastroenterology

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Eosinophilic Gastrointestinal Diseases (EGIDs) are a group of diseases where eosinophils (a type of white blood cell) abnormally infiltrate the lining of the gastrointestinal tract (GI tract) in large numbers, causing inflammation. Depending on the part(s) of the GI tract involved, various names can be given to the different types of EGIDs. For example, if only the esophagus has abnormal eosinophils in its lining, this is called Eosinophilic Esophagitis. On the other hand, if only the colon is involved, this is referred to as Eosinophilic Colitis. In some children, more than one area can be involved.

Symptoms

Depending on the part(s) of the GI tract involved, symptoms will vary. If the esophagus (food pipe) is involved, a child may have difficulty swallowing or complain of heartburn or abdominal pain. If the colon is involved, a child may have diarrhea or blood in stools. If the small intestine is involved, a child may have poor absorption which could then lead to weight loss or nutrient deficiencies.

Causes

The exact cause of most EGIDs is still unknown, but is a topic of much ongoing research and study. EGIDs are believed to arise from an abnormal trigger of the body’s immune system, possibly from allergies or autoimmunity. 

Diagnosis 

The diagnosis of an EGID requires a doctor to ask the right questions, do a thorough exam, and also do additional tests, which may include blood or stool tests, but almost always includes esophagogastroduodenoscopy and colonoscopy with biopsies to examine the tissue for eosinophilis.

Treatments

For some children, elimination of a food to which they are allergic is all that is required. For others, medications or a combination of medications and dietary therapy (elimination diets) will be necessary. Most families will need nutritional counseling from a pediatric dietician and some may benefit from supplements, including special hypoallergenic formulas and food. 

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