Treating Eosinophilic Gastrointestinal Diseases

Eosinophilic gastrointestinal diseases (EGIDs) are a group of rare diseases that affect different parts of the gastrointestinal (GI) tract.

EGIDs form when eosinophils (white blood cells linked to allergies) build up in the lining of the GI tract. Increased numbers of these cells can cause swelling and other symptoms based on the affected part of the GI tract.

UPMC Children's Hospital of Pittsburgh's team of EGID experts provides groundbreaking treatments to help children manage these lifelong conditions. Our goal is to help your child live a healthy life.

Call the Center for Pediatric Eosinophilic Gastrointestinal Disorders at UPMC Children's Hospital at 412-692-5180.

EGID Treatments at UPMC Children's Hospital

All infants and children diagnosed with an EGID can benefit from treatment, but it's crucial for those with severe symptoms.

While treatments won't cure this condition, they can help manage symptoms and prevent scar tissue formation and build-up.

The goals of EGID treatments are to improve your child's quality of life and let them eat, grow, and stay healthy.

Our EGID specialists use advanced tests to thoroughly assess suspected EGIDs.

Because EGIDs are complex, chronic conditions, we take time to explore the best treatment options for your child and family.

Often, children benefit from a mix of therapies.

Diet changes to treat EGID

Many children improve when they cut out potential trigger foods such as:

  • Milk
  • Wheat
  • Eggs
  • Soy
  • Nuts
  • Seafood

A registered dietitian with expertise in EGIDs will help pinpoint foods to remove from your child's diet. They'll make sure your child has plenty of healthy, nutritious food choices, and work with you on how to replace lost nutrients.

You'll also work closely with your child's GI doctor, allergist, and occupational therapy feeding specialist, if needed.

They'll check on your child to make sure their EGID symptoms improve and adjust treatment if necessary.

Medicine to treat EGID

  • Proton pump inhibitors block stomach acid that can irritate the inflamed esophagus and also reduce swelling in the esophagus directly.
  • Swallowed steroids can reduce inflammation in the esophagus and other parts of the digestive tract.
  • Dupilumab (DUPIXENT®) is a weekly injectable treatment given under the skin for children older than 12 who weigh more than 88 pounds. It targets an underlying source of inflammation.

Your doctor will discuss the pros and cons of different drugs before starting them. They'll also check for any potential side effects your child may have.

Dilation to treat EGID

Doctors perform this procedure during an endoscopy that can open blockages of built-up scar tissue in the esophagus and the intestine.

Lifestyle treatments for EGID

Your child and family may also benefit from:

  • Speech and occupational therapy to help manage feeding problems that may arise due to EGIDs.
  • Behavioral health support to help through the challenges of living with an EGID. We can help you with any emotional, social, or behavioral issues your child or family might face. You can work with us any time during or after your child's treatment.

EGID Treatments Benefits and Risks

Treatments for EGIDs can greatly improve your child's quality of life and overall health.

Diet changes and lifestyle treatments — like speech or occupational therapy — may take some time to get used to. But these are often highly effective and have little to no risks or downside.

Some medications to treat EGIDs have a small risk of adverse reactions. Your child's doctor will closely watch how your child reacts to their medicine and make changes if needed.

Risk and benefits of diagnostic tests for EGID

To properly treat EGID, you must have a correct diagnosis first.

Two common procedures to help confirm an EGID diagnosis are endoscopy and colonoscopy.

  • An endoscopy lets your doctor examine and take small tissue samples of the esophagus, stomach, or small intestine. They'll insert a thin, flexible tube — called an endoscope — into your child's nose or throat and guide it into the upper GI tract.
  • A colonoscopy lets your doctor to observe and take small tissue samples of the colon. They'll insert a flexible tube — called a colonoscope — into the anus and guide it through the rectum into the colon.

Both tubes have cameras that allow your doctor to see the GI tract. They also have forceps (pinchers) to collect a tiny tissue sample.

Both procedures have slight risks of:

  • Bleeding.
  • Perforation, or a tear in the GI tract.
  • Infection.

The benefits of a clear diagnosis mostly outweigh any slight risk from these tests.

Based on the type of EGID your doctor suspects, they may perform one or both tests to confirm a diagnosis. They may also perform them to check how well a treatment is working.

Testing and finding the right treatments for EGIDs can take time and visiting doctors can be stressful for kids.

The EGID team at UPMC Children's cares for your child with warmth and compassion. We go the extra mile to make sure your child feels comfortable and supported throughout all procedures and treatments.

What to Expect Before, During, and After EGID Treatment at UPMC Children's

Our Center for Pediatric Eosinophilic GI Disorders uses a family and patient-centered team approach to provide quality care.

With this approach, a team of experts from many medical specialties works together to address all aspects of your child's health.

Here's what to expect when you come to us for care.

Before your child's EGID treatment

EGID treatment starts with an accurate diagnosis. A pediatric gastroenterologist and, if needed, an allergist will see your child.

They may suggest your child have:

  • An esophagram — an imaging test — to look at pictures of the esophagus.
  • A CT scan to look at pictures of other areas of the digestive tract.
  • Endoscopy or colonoscopy to view parts of the GI tract and take small tissue samples.

Often the scariest parts of the process are when the doctor checks your child's digestive tract and collects tissue samples to biopsy. But these steps are vital because they can confirm an EGID and help your child's GI doctor design a treatment plan.

Our team will make your child feel as relaxed as possible.

Your doctor will give you any special instructions for these tests. They'll also tell you where to go and when to arrive.

In most cases, blood or imaging tests won't require your child to do anything special before.

For an endoscopy, though, your child shouldn't eat for at least six hours before the test.

During your child's EGID treatment

Your child's GI doctor will review all test results with you.

If the biopsy results confirm an EGID, our experts will work with your family to decide the best treatment options.

We'll tailor your child's treatment based on their unique needs and your family's wishes.

After your child's EGID treatment

Because EGIDs are chronic, your child will need ongoing treatment.

Your child's GI doctor will continue to see them to make sure:

  • EGID symptoms are well-controlled, and tissue is healthy on biopsies.
  • No new symptoms appear.
  • They're eating, growing, and developing as they should.

Depending on how your child responds to treatment, your doctor might suggest more tests. They may also make changes to your child's diet or medicine.

Contact the Center for Pediatric Eosinophilic GI Disorders

We welcome referrals from doctors in Southwest Pa. and beyond. Parents can also schedule their child's appointment directly.

To learn more or make an appointment with a pediatric EGID expert, call 1-412-692-5180.

The center's main location is at UPMC Children's Campus in Pittsburgh's Lawrenceville neighborhood.