Eosinophilic gut disease

Eosinophilic gastrointestinal disease: EGID symptoms in children

Eosinophilic gastrointestinal disease (EGID) is a rare condition, with around 1 in 1,500 children affected, but it has been increasingly diagnosed over the past ten to fifteen years. 

Although rare, it’s important to know the signs and symptoms of this condition so that you can identify EGID in your child and seek medical treatment for them. 

What is EGID?

EGID is characterised by chronic inflammation in the gastrointestinal tract, caused by a higher-than-normal number of eosinophils – these are a type of white blood cell that helps protect against parasites but can also cause allergic inflammation. Eosinophils make up less than 7% of white blood cells in the blood.

This increase can cause tissue damage and irritation in the gastrointestinal tract resulting in your child experiencing a number of uncomfortable and unpleasant symptoms. 

There are four types of paediatric EGID, with the location of the condition determining the type:

  • Eosinophilic esophagitis affects the oesophagus – this is the most common type of EGID
  • Eosinophilic colitis affects the large intestine
  • Eosinophilic gastroenteritis affects both the stomach and small intestine 
  • Eosinophilic gastritis affects the stomach lining

What are EGID causes and risk factors?

In eosinophilic gastrointestinal disease, there isn’t any evidence of underlying causes – such as infection or cancer – for the increase in eosinophils.

What causes the increase in eosinophils resulting in EGID is not completely clear, but it’s thought that it may be triggered by allergies, an infection or acid reflux. 

While EGID can affect any child, it appears that sex and genetic factors are associated with the disease. EGID is more common in males than females, and around 10% of those with EGID have an immediate family member with the condition. 

Research has also found that 70 to 80% of children with EGID will have allergic disorders such as asthma, hay fever, eczema or food allergies

EGID symptoms

The symptoms your child may experience depend on the type of eosinophilic gastrointestinal disease they have. 

EGID symptoms and signs to look out for include:

  • Abdominal pain
  • Chest pain
  • Difficulty eating or feeding
  • Difficulty moving from liquid to solid foods
  • Pain when swallowing
  • Refusing to eat or fussiness when eating
  • Vomiting, acid reflux or silent reflux
  • Bloating
  • Diarrhoea
  • Mucus or blood in their poo
  • Poor growth, malnutrition and weight loss

Diagnosing your child with EGID

EGID is often misdiagnosed because the symptoms are similar to other more common conditions. To properly diagnose EGID, you will first need to provide a full and detailed medical history for your child.

Allergy testing in the form of a blood test, skin prick testing or patch testing may then help pinpoint whether your child’s symptoms are caused by allergies or another condition such as coeliac disease. 

Your child may also need to have an endoscopy so that a small biopsy can be taken for analysis to look for raised levels of eosinophils. An endoscopy is where a thin tube with a camera on the end is inserted into your child’s mouth, and passed through the oesophagus, stomach and small intestine while they are under sedation or anaesthetic. 

How is EGID treated?

The treatment of paediatric EGID depends on which part of your child’s gastrointestinal tract is affected and the severity of the condition. 

In most cases, treatment will take a two-pronged approach, combining avoidance of triggers through dietary management and reduction of inflammation with medicines or procedures. 

Dietary management to avoid EGID triggers

  • Allergen elimination diet – removing common trigger foods from your child’s diet, most commonly cow’s milk, soy, eggs, wheat and sometimes other foods, may halt the increase of or reduce the eosinophils and symptoms experienced
  • Targeted elimination diet – if allergy testing has identified specific foods your child is allergic to, it’s important to eliminate them completely from their diet to stop eosinophils increasing 

Treatments to reduce inflammation

  • Proton pump inhibitors – these are oral medications that treat acid reflux to help bring down inflammation in the oesophagus 
  • Topical steroids – drinkable or inhalable steroids are often recommended to help reduce inflammation in the oesophagus when proton pump inhibitors have been ineffective
  • Oesophageal dilation – if your child’s oesophagus has narrowed they may need to have an endoscopic procedure to dilate (stretch) it to make swallowing easier. This procedure is only used in cases where other dietary or medicinal treatments have been unsuccessful

How Children’s Allergy Doctors can help 

We know that getting your child’s symptoms diagnosed and finding treatment can be distressing. At Children’s Allergy Doctors, we provide comprehensive assessment and diagnosis and the very best care for your child. 

Through detailed history taking, examination and – where appropriate – allergy testing, our experts will assess whether it’s likely your child is experiencing EGID symptoms because of a food allergy or another condition. 

We’ll provide the next steps on how to confirm whether your child’s symptoms are being driven by a delayed food allergy, usually by the exclusion of the offending food followed by reintroduction. 

We also ensure that any changes to your child’s diet or your diet (if you’re breastfeeding) do not lead to any nutritional deficiencies. 

If your child is displaying EGID symptoms, get in touch with our friendly team today to book a consultation.

 

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