Eosinophilic Gastrointestinal Disease Explained
An Eosinophilic Gastrointestinal Disease (EGID) is a digestive system disease where eosinophils are found in above-normal amounts in one or more places in the digestive system and/or blood.
Eosinophils are a normal cellular component of the blood and certain tissues, including spleen, lymph nodes, thymus, and the submucosal areas of the gastrointestinal, respiratory, and genitourinary tracts. Counts of 0 to 450 eosinophils per cubic millimeter of blood are considered within normal limits. Eosinophilic disorders occur when eosinophils are found in above-normal amounts in various parts of the body.
When the body wants to attack a substance, eosinophils respond by moving into the area and releasing a variety of toxins. When the body produces too many eosinophils, they can cause chronic inflammation and result in tissue damage.
There are many diseases where eosinophils have been found elevated in the blood or different tissues. General categories of disease range from allergic disorders to endocrine disorders. EGIDs can be divided into primary and secondary types. The primary type is has allergic and non-allergic forms. The allergic type is associated with food allergies while the non-allergic form occurs when no obvious cause can be found.
Diagnoses are made based on where the elevated levels of eosinophils are found. Click below to read more at the Mayo Clinic.
Symptoms
- Pain
- Swelling
- Skin Rash
- Hives
- Reflux
- Choking
- Difficulty Swallowing
- Nausea
- Vomiting
- Loss of Appetite
- Stools Containing Blood and/or Mucus
- Abdominal Cramping
- Diarrhea
- Pseudopolyps
- Protein Loss
- Anemia
- Malabsorption
- Developmental Delay
- Bleeding
- Nutritional Deficiencies
Treatment Options
Since there is no known cure for EGIDs, management of the condition is needed in order to prevent severe damage to the digestive system (and to the organs in the case of Hypereosinophilic syndrome) caused by the high numbers of eosinophils. Because symptoms vary so widely and may mimic other conditions, it is important to have accurate information and awareness of EGIDs.
Dietary Treatment
For those who are unable to obtain enough nutrition from food alone, amino acid-based formula may be needed as a supplement. Some primary disease types may require the avoidance of foods and complete reliance on an amino acid-based formula. These may be consumed normally or pumped through a special feeding tube (naso-gastric, gastrostomy, or jejunostomy tubes).
For the most severe flare-ups or for those who experience problems from all foods and formulas, feeding through a blood vessel (TPN) may be the only remaining option.
Medication
Pain medication may be needed for specific symptoms. This disease may cause severe bleeding or nutritional deficiency that it may be life-threatening if not treated with appropriate medications.
Comorbid Diseases with Elevated Eosinophils
Allergic Disorders
Allergic rhinoconjunctivitis (hay fever) in the nasal muscosa, asthma in the lung, other allergic conditions
Drug Reactions
Allergic reactions to a drug in blood or tissues where it is concentrated
Infectious Diseases
Parasitic infections (helminthiasis − worms), fungal infections, and some other types of infections
Blood Diseases
Hematologic disorders including hypereosinophilic syndrome, leukemias, lymphomas, tumors, mastocytosis, and atheroembolic disease
Immunologic Diseases and Reactions
Hyper-IgE syndrome, Omenn’s syndrome, thymomas, transplant rejections and other conditions
Endocrine Diseases
Hypoadrenalism
Elevated Eosinophils With Organ Involvement
Skin and Subcutaneous
Atopic dermatitis (eczema), bullous pemphigoid, pemphigus vulgaris, dermatitis herpetiformis, drug-induced lesions, urticaria, eosinophilic panniculitis, angioedema with eosinophilia, Kimura’s disease, Shulman’s syndrome, Well’s syndrome, eosinophilic ulcer of the oral mucosa, eosinophilic pustular folliculitis, recurrent cutaneous necrotizing eosinophilic vasculitis
Pulmonary
Drug/toxin-induced eosinophilic lung disease, Loeffler’s syndrome, allergic bronchopulmonary aspergillosis, eosinophilic pneumonia, Churg-Strauss syndrome, eosinophilic granuloma, pleural eosinophilia
Gastrointestinal
Gastroesophageal reflux, parasitic infections, fungal infections, Helicobacter pylori infections, inflammatory bowel disease (ulcerative colitis and Crohn’s disease), food allergic disorders, protein-induced enteropathy and protein-induced enterocolitis, allergic colitis, celiac disease, pemphigus vegetans (MR) and primary eosinophilic esophagitis, gastroenteritis, colitis, rare tumors (leiomyomatosis), connective tissue diseases, and vasculitic diseases
Neurologic Disorders
Organizing chronic subdural hematoma membranes, central nervous system infections, ventriculoperitoneal shunts, drug-induced adverse reactions
Cardiac
Secondary to systemic disorders such as the hypereosinophilic syndrome or the Churg-Strauss syndrome, certain congenital heart conditions such as septal defects, aortic stenosis
Renal
Eosinophiluria (eosinophils in the urine) is associated with infections or interstitial nephritis and eosinophilic cystitis
Eosinophils In Detail
The eosinophil is a specialized cell of the immune system. This pro-inflammatory white blood cell generally has a nucleus with two lobes (bilobed) and cytoplasm filled with approximately 200 large granules containing enzymes and proteins with different (known and unknown) functions.
Eosinophils are formed exclusively in the bone marrow, where they spend about 8 days in the process of maturation before moving into the blood vessels. They travel through the vessels for 8 to 12 hours before they finally arrive at destination tissues, where they remain for 1 to 2 weeks. Interleukin 5 (IL-5) appears to be the major growth factor for this type of cell.
The functions of the eosinophil are varied, some of which are very similar to other white blood cells. They are implicated in numerous inflammatory processes, especially allergic disorders. In addition, eosinophils may have a physiological role in organ formation (e. g. postgestational mammary gland development).
Eosinophilic functions include moving to inflamed areas, trapping substances, killing cells, antiparasitic and bactericidal activity, participating in immediate allergic reactions, and modulating inflammatory responses.
Eosinophils can be either helpful or harmful. At one extreme, such as in the illness erythema toxicum, eosinophils play the role of a beneficial modulatory element or an innocent bystander. At the other extreme, represented by conditions like Loeffler’s disease and idiopathic hypereosinophilic syndrome, eosinophils are linked with permanent pathologic changes.
Sedation-Free TNE
- “Sedation-Free Transnasal endoscopy (TNE) is a minimally invasive medical procedure performed by a physician intended to examine the digestive tract. It involves inserting an endoscope through the nose, advancing down through the esophagus (food pipe), stomach, and part of the small intestine (duodenum) to look at and treat conditions of the upper digestive tract.
Why Sedation-Free TNE?
It eliminates the risks associated with general anesthesia and reduces overall exposure to anesthetic agents for you or your loved one. Moreover, it cuts down on pre- and post-procedure time, resulting in shorter office visits and a quicker return to regular activities. Lastly, its single-use disposable design significantly reduces the risk of cross-contamination, which can occur with reusable equipment commonly employed in endoscopic examinations.
Overall, it’s a safer and more convenient alternative for diagnostic endoscopic exams of the upper GI tract!
Sedation-Free Benefits
• “Sedation-Free, no more going to sleep!”: This procedure is done while awake, eliminating the complications and inconveniences associated with general anesthesia.
• “Needle-Free and Minimal Fasting Required”: Enjoy a simpler preparation with no need for IVs and only brief fasting before the procedure.
• “Enhanced Safety with Single-Use Scopes”: Benefit from our use of sterile, single-use scopes that significantly reduce the risk of cross-contamination.
• “Efficient and Convenient”: Spend less time preparing for and recovering from your procedure, allowing you to quickly return to work, school, or other daily activities.
How it works or what to expect:
A numbing agent will be applied to your nasal passages to make you more comfortable.
You might receive an EvoEndo Patient Experience Kit with items designed to provide distraction during the procedure.
Once ready, the doctor will gently insert the EvoEndo Scope through your nose. It will travel down through the esophagus (food pipe), stomach, and part of the small intestine (duodenum).
If needed, very small tissue samples called biopsies may be taken through the EvoEndo Scope using special forceps. Air and water may also be used to make it easier for the doctor to see.
Patient Testimonials
Hear from our patients who have experienced the benefits of Sedation-Free TNE firsthand.
Patient 1: “Having had traditional endoscopies before, I was amazed at how much less discomfort I experienced with Sedation-Free TNE. It was quick, and I was back to my normal routine in no time.”
Patient 2: ‘I was a bit nervous about getting an endoscopy without sedation, but I was amazed by how smooth and comfortable the whole process was. The numbing agent made sure I felt no discomfort, and the procedure was over before I knew it. Being able to walk out of the clinic on my own and head straight back to school was incredible. I couldn’t believe I could feel myself again so quickly!’
FAQs for Patients and Families
Explore our Frequently Asked Questions to learn more about TNE, including what to anticipate before and after the procedure, how it will be conducted, and much more!
Find a Physician (Optional)
Locator Tool: “Not sure where to find a TNE specialist? Use our easy Physician Finder tool to locate experienced providers in your area.”
Source: EvoEndo