Delayed EGID Diagnosis Can Impair Growth in Children

A recently-published study in the Italian Journal of Pediatrics investigating 60 paediatric patients with eosinophilic gastrointestinal disorders (EGIDs) has shown that delayed diagnosis can impair the child's growth.

Issues caused by EGIDs, most prominently in this study difficulty eating and diahorrea-related weight loss, can lead to Failure To Thrive (FTT) - a term for when a child's weight or rate of weight gain is significantly below that of other children of similar age and sex.

However, these issues caused by EGIDs were not being recognised and promptly diagnosed.

Participants and findings

The year-long study examined young patients receiving treatment for EGIDs at a Centre in Pavia, Italy. 39 had a diagnosis of eosinophilic oesophagitis (EoE), and 21 had a diagnosis of a lower-gut EGID.

The most common age at diagnosis was 6 to 11 years old, and the most common time from first symptom to diagnosis was 12 months across both the groups with EoE and lower EGIDs. The longest time was 24 months for school-age children and 12 months for adolescents.

EoE group

Those with EoE were more likely to have coexisting allergies, with 70% of the group having at least one, and allergic rhinits being the most prevalent.

Issues specific to those with EoE were feeding issues (18% of the group), food impaction (21%), and dysphagia (23%).

26% of the group was observed to have failure to thrive. FTT predisposed them to longer diagnostic times compared to the children without such issues. Even having a symptom indicative of EoE, such as food impaction, was not associated with shorter diagnosis times.

Lower gut EGID group

The lower EGID group were slightly less likely to have coexisting allergies, at 52%.

Diarrhoea and associated weight loss was seen in 38% of this group, but as with the EoE group, these symptoms did not result in quicker diagnosis.

FTT was less common in the lower EGID group, at only 10%.

The authors concluded:

This study highlighted that it is fundamental to identify all delay points, starting with raising awareness among family pediatricians on EGIDs and promptly referring suspicious cases. Multidisciplinary pediatric evaluation and close collaboration with endoscopists and pathologists are pivotal in early identifying suspected cases, monitoring confirmed cases of EGIDs, and preventing potential growth complications

The authors also noted that their cohort's average time to diagnosis was significantly shorter than other studies have found (see links below).

EOS Network's mission is to ensure that every person with an Eosinophilic Gastrointestinal Disease receives a prompt accurate diagnosis, the right treatment for them, and support to live with their condition.

If you can, please donate to our charity so that we can continue to provide educational resources and events for healthcare professionals to help them recognise symptoms, diagnose and treat EGIDs.

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Author: Alex Boulding

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