Eosinophilic gastrointestinal diseases (EGIDs) cause inflammation in your child’s digestive tract. They happen when a type of white blood cell called an eosinophil builds up in the digestive system.

Eosinophils help the body fight off infections and react to allergens. Normally, they are not found in large numbers in the stomach or intestines. In these diseases, eosinophils gather and cause swelling, pain and other symptoms.

These conditions can affect different parts of the digestive system, including the:

• Esophagus
• Stomach
• Small intestine
• Colon

Kids can have eosinophils infiltrate more than one part of the digestive tract at a time. Some kids also have other allergic issues like asthma, eczema or seasonal allergies. EGIDs are more common in school-age kids and in boys.

We don’t know what causes EGIDs. In some cases, the condition may run in families.

There are different types of EGID based on which part of the digestive tract has too many eosinophils.

Eosinophilic Esophagitis

Eosinophilic esophagitis (EoE) happens when eosinophils build up in the esophagus. This tube connects the throat to the stomach. Swelling can make it hard or painful for your child to swallow. This can affect how well they eat or grow.

Common symptoms include:

• Feeding problems
• Avoiding food
• Vomiting
• Slow weight gain
• Chest or stomach pain
• Reflux that doesn’t get better with medicine
• Trouble swallowing
• Food getting stuck in the throat

Eosinophilic Gastritis

Eosinophilic gastritis is EGID in the stomach. It can lead to digestive symptoms that make it hard to eat enough to grow.

Symptoms may include:

• Belly pain
• Diarrhea
• Vomiting
• Weight loss or poor weight gain

Other Rare Types

EGID can also affect the small intestine (eosinophilic enteritis) or the colon (eosinophilic colitis). These forms are even less common. Your child’s care team can check which parts of the digestive system show inflammation.

We tailor a care plan based on your child’s symptoms, diagnosis, age and overall health.

It often involves a mix of:

• Elimination diet: We remove common food triggers like milk, soy, eggs, peanuts, wheat and seafood. If symptoms improve, we slowly add foods back to find out which ones are safe.
• Endoscopy: We use a thin tube with a light and camera to see your child’s esophagus or stomach. We’ll go back and check over time to see if the treatment is working.
• Medicine: Your child may take swallowed steroids or biologic medicines to reduce inflammation.
• Nutritional support: If your child has trouble eating or gaining weight, we may use a liquid formula to make sure they get the nutrients they need.
• Feeding tube: For kids who can’t eat enough by mouth, a feeding tube can provide full nutrition safely and effectively.

EGID treatments are similar for different parts of the digestive tract. There are some differences. For example, kids with EoE may need a procedure to stretch a narrowed esophagus. Kids with eosinophilic gastritis may need a different mix of medicines to reduce inflammation throughout the stomach.

At Children’s Wisconsin, your child will get care from one of the nation’s leading programs for EGIDs.

We also offer state-of-the-art treatments, including esophageal dilation and transnasal endoscopy. Our experts work together to manage all parts of your child’s care.

Your child’s care team may include:

• Pediatric gastroenterologists who specialize in EGIDs
• Allergists from our Allergy and Clinical Immunology Program
• Dietitians with training in food allergies and nutritional therapy
• Pediatric psychologists
• Nurses and support staff with expertise in chronic GI conditions

Your First Visit

At the first visit, we’ll take time to understand your child’s full health story. This includes their symptoms, growth patterns, allergy history and past test results. We may suggest one or more tests to confirm a diagnosis

These include:

• Upper endoscopy and biopsy: This test lets us see inside the digestive tract and collect small tissue samples to check for eosinophils.
• Barium swallow study (for EoE): Shows how food moves through the esophagus.
• Allergy testing: May help identify food triggers.
• Blood or stool tests: Can check for signs of inflammation, allergy or malabsorption.

After diagnosis, we’ll talk through the best care options for your child.

During Treatment

You’ll stay closely connected to your care team throughout treatment. We’ll monitor your child’s growth, symptoms and response to treatment. This may involve follow-up visits, repeat endoscopies or updates to your child’s care plan.

Your child will also have access to:

• Nutrition care to support feeding and growth
• Therapy to help with stress, anxiety or eating challenges
• Education and support for long-term diet changes

It may take time to find the right plan, especially if your child has multiple allergies or ongoing symptoms. We’re here for every step of that process.

After Care

EGIDs are long-term health issues that require ongoing care. With the right care plan, most kids can manage their symptoms and stay healthy.

Your child may need:

• Long-term diet changes or medicine to keep inflammation under control
• Follow-up visits and repeat testing to monitor progress
• Ongoing support from our digestive doctors, allergists and dietitians

EGIDs can flare up or go into remission. If symptoms improve, it’s key to stick with the care plan and follow up regularly. Your care team will help adjust your child’s plan as they grow.