Gut Biopsies for EGIDs Diagnosis: What to Expect and Why They Matter Gut Biopsies in Eosinophilic Gastrointestinal Diseases (EGIDs) Gut biopsies are essential in diagnosing and managing Eosinophilic Gastrointestinal Diseases (EGIDs), including Eosinophilic Oesophagitis (EoE) and Eosinophilic Gastritis (EoG). A biopsy is a small tissue sample taken from the lining of the gastrointestinal tract, which is then examined under a microscope to detect eosinophils and other signs of inflammation. During a gut biopsy, a gastroenterologist uses an endoscope (a flexible tube with a camera and tiny tools) to collect samples from specific areas of the gut. A gastroscopy is a type of endoscopy specifically used to examine the upper gastrointestinal tract, including the oesophagus, stomach, and the first part of the small intestine. During a gastroscopy, small tissue samples (biopsies) can be taken to help diagnose conditions like EoE or EoG (when the stomach is affected). A lower gastrointestinal endoscopy, often called a colonoscopy, is a procedure in which a flexible tube with a camera is inserted through the rectum to examine the colon and, sometimes, the end of the small intestine. This allows doctors to detect inflammation, swelling, or other abnormalities in the lower digestive tract. During the procedure, biopsies can be taken to check for eosinophil infiltration and other signs of Eosinophilic Colitis (EoC), Eosinophilic Enteritis (EoN) and also for EoG if the small or large intestine is involved. Interpreting Eosinophil Counts Interpreting eosinophil counts from gut biopsies can be challenging. Eosinophil infiltration is often patchy, meaning some areas of the gut may appear normal while others show significant inflammation. Counts can also vary depending on biopsy depth, the exact site sampled, and individual patient factors. This variability makes standardised reporting and careful pathological assessment essential for accurate diagnosis and effective treatment planning. By combining endoscopy with targeted biopsies and careful interpretation of eosinophil counts, clinicians can more accurately identify disease location, severity, and pattern, guiding personalised treatment and improving outcomes for patients with EGIDs. Whilst this is still a pathology job mainly being undertaken by the human eye, we are keen to understand the future possibilities of AI, which we explored in our webinar with leading experts in the field. Watch the Webinar: Gut Biopsies in Eosinophilic Gastrointestinal Diseases (EGIDs) Presented by: Margaret Collins, MD. Professor, Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Department of Pediatrics (secondary), Cincinnati Children’s Hospital Medical Center, Cincinnati, OH Yonatan (Yoni) Savir. Assoc Professor, Technion – Isreal Institute of Technology Dive into the role of biopsies in diagnosing and managing EGIDs and Eosinophilic Oesophagitis (EoE). Help us to develop more resources like this Key Topics Covered: By Dr. Margaret Collins: Why is a biopsy required and important in EGIDs Pathologists’ role in EGID diagnosis and biopsy processing Pathology reports Diagnosis EGIDs biopsy samples Eosinophilic Oesophagitis (EoE) diagnosis Standardised reporting: EoE Histology Scoring System (EoEHSS) Eosinophilic Gastritis (EoG) pathologic features EoG Biopsy differential diagnosis Eosinophilic Duodenitis (EoD) pathologic features EoD differential diagnosis Eosinophilic Colitis (EoC) pathological features and differential diagnosis Mast cells in biopsy Challenges in the pathology. Conclusions and future directions By Prof. Yoni Savir: The hierarchy of AI needs in pathology AI in personalised medicine Multiple data modalities: From diagnosis to treatment management AI in Eosinophilic Oesophagitis (EoE) pathology & diagnosis (example) PECNet: a multi-label segmentation model Going beyond the global score: harnessing the entire distribution of information Identifying novel biomarkers for EoE severity prediction The Era of representation learning AI in Typical EoE treatments’ research, and diet assignment Multi-modal data integration Summary Additional Resources Discovering Mast Cells' Role in Eosinophilic Oesophagitis with Machine Learning Eosinophilic Diseases Research: Past, Present and Future EndoSign® Device: Lead Researcher Sarah Killcoyne's Interview Total Wall Thickness: A New Diagnostic Tool for Paediatric Eosinophilic Oesophagitis Screening data from ENIGMA study reveals under-diagnosis of EG and EGE This resource was developed with support from the National Lottery Community Fund. Manage Cookie Preferences