Welcome to Adult & Pediatric Allergy Center of Northern Virginia

Eosinophilic Gastrointestinal Disorders

Eosinophilic Gastrointestinal Disorders (EGID) result from an increased number of an inflammatory cell, called an eosinophil, in the lining of the digestive tract. The most commonly affected area is the esophagus (food pipe) and this is called Eosinophilic Esophagitis (EoE). 

This is a newly recognized group of disorders that has been increasingly diagnosed over the past decade. It may affect children and adults.

What are symptoms of EGID/EoE?

Symptoms of EGID/EoE may vary with age, but commonly include:

  • ‍Gastroesophageal reflux (acid reflux)
  • ‍Dysphagia (difficulty swallowing)
  • ‍Food impactions (a bite of food becomes stuck in the esophagus)
  • ‍Nausea and Vomiting
  • ‍Failure to thrive (poor growth or weight loss)
  • ‍Poor appetite
  • ‍Abdominal or chest pain

How is EGID/EoE diagnosed?

The diagnosis is made by obtaining biopsies (samples of tissue) from the lining of the digestive tract in various locations. This is done by a gastroenterologist.

The majority of individuals with EGID have a family history of allergies and may have symptoms of other allergic disorders such as asthma, nasal allergies, or atopic dermatitis. Food allergy is a major, yet complex, cause of EGID. Therefore, an allergist can determine the role of allergies in the condition. We will work together with your gastroenterologist to make diet and treatment recommendations.

EGID/EoE abdominal pain, man clutching stomach in discomfort

What role does an allergist have in diagnosing/managing EoE?

Once the diagnosis of EGID has been made, your allergist will perform skin prick testing to evaluate for sensitivity to foods known to be highly associated with EGID and any other suspect foods. Blood tests have not been as helpful in identifying causative foods in EGID.

Food patch testing is another type of testing that may be used in the evaluation of EGID. Patch testing evaluate for a delayed reaction to specific foods. However, this testing is not standardized which makes it somewhat difficult to interpret. Its reliability and value in the treatment of EGID is somewhat controversial.

If specific foods are positive on skin testing, your allergist will recommend an elimination diet. There are a few foods which have been highly associated with EGID even with negative skin tests in research studies. Your allergist may recommend eliminating these foods. For some people, food avoidance is the only treatment required to control EGID. Pollen and environmental allergies may contribute to EoE. Allergy Immunotherapy in certain patients may be beneficial.

There are currently no medications approved by the FDA specifically for the treatment of EGID. However, many research studies have shown that swallowed steroids from an inhaler typically used to treat asthma can be effective in controlling EoE.

Your gastroenterologist will determine when biopsies should be repeated to see if the condition has improved. This result will help to guide possibly stopping medications and/or reintroducing foods to the diet.

Back to Conditions