Eosinophilic Gastrointestinal Diseases (EGIDs): Symptoms, Diagnosis & Treatment Guide

Overview  

Eosinophilic Gastrointestinal Diseases (EGIDs) affect the digestive tract and are part of a broader family of type 2 inflammatory conditions. Often, people affected have these conditions alongside other allergic or immune-related conditions, such as asthma, eczema, hayfever and/or other allergies. 

Managing EGIDs requires a holistic approach that recognises the complex interactions among the immune system, diet, and daily life. By addressing cohesive medical care needs, including nutrition, mental health, and overall quality of life, patients and healthcare professionals can together improve outcomes and support long-term well-being whilst living with EGIDs and related eosinophilic conditions.

Understanding the Gastrointestinal Tract

The gastrointestinal (GI) tract is divided into two main regions. Depending on which part of the gut is affected, there are different types of EGIDs.

Upper Gut – Oesophagus and Stomach: These organs are responsible for the initial breakdown of food and the movement of nutrients into the digestive system. Conditions like Eosinophilic Oesophagitis (EoE) primarily affect this region. 

Lower Gut – Small intestine (bowel) and Large Intestine (colon): The small intestine absorbs nutrients, while the large intestine processes waste. EGIDs, such as Eosinophilic Gastroenteritis, Enteritis and Colitis, impact these areas, influencing digestion, absorption, and overall gut health.

Whole Gut. Eosinophilic Gastrointestinal Diseases (EGIDs). Part 1. 

Presented by:

• Dr. Salvatore Oliva, Specialist in Paediatric Gastroenterology and Digestive Endoscopy, Policlinico Umberto I - Sapienza University of Rome.
• Evan S. Dellon, MD, MPH, Professor of Medicine. Director, Center for Esophageal Diseases and Swallowing, UNC School of Medicine in the Division of Gastroenterology and Hepatology

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Learn about EGIDs and type 2 inflammatory gut conditions, including:

1. Different parts of the gut affected, and the terminology
2. History, prevalence and Incidence
3. Causes and risk factors
4. Kids to adults: signs and symptoms in the gut and beyond
5. Diagnosis: relevant tests and accurate results: what, why, how and when

Topics covered in Part 1:

1. What is an eosinophil? Their functions and localisation.  Are GI eosinophils normal?
2. What is an EGID: definition, classification, and a new nomenclature system
3. A brief history of the EGIDs: first cases, EGIDs in literature
4. What is epidemiology? Observational and cohort studies and applying epidemiology to EGIDs
5. Are EGIDs rare? Global incidence and the increasing prevalence of eosinophilic esophagitis (EoE)
6. Burden of EoE on emergency departments (US)
7. EoE Diagnostic delay
8. Epidemiology of non-EoE EGID: diagnostic delay and possibility of under-diagnosis
9. News data: prevalence/costs of Non-EoE EGIDs (US)
10. Overlapping non-EoE EGIDs in patients with EoE
11. How to join research projects at egidpartners.org
12. EoE pathophysiology: cases and presentation, prevalence, sex ratio, eosinophil count thresholds, allergic aetiology and other features
13. EGIDs and Allergy: allergic rhinitis, sinusitis, dermatitis, asthma and other conditions commonly found in patients with EGIDs
14. Clinical presentation of EGIDs in children and adults: symptoms, extent, depth
15. Differences in clinical presentation of EGIDs between children and adults
16. EGID Symptoms beyond the gut: clinical presentation and frequency
17. Diagnosis: EoE and non-EoE EGIDs diagnostic criteria, tests and markers and endoscopy as a main diagnostic tool
18. Diagnostic delay of EGIDs: symptoms recognition, endoscopy, histopathological evaluation and differential diagnosis

Whole Gut. Eosinophilic Gastrointestinal Diseases (EGIDs). Part 2. 

1. Nirmala Gonsalves, MD, Associate Professor of Medicine (Gastroenterology and Hepatology), Northwestern Medicine Feinberg School of Medicine
2. Kathryn A. Peterson, MD, MSCI, Professor of Gastroenterology, University of Utah Health

Discover practical guidance on treating and managing EGIDs, including:

• Treatment options with medications and elimination diets
• Taking a holistic approach to improve quality of life
• Long-term management, follow-up care, and multi-specialist coordination
• Insights into future research, evolving treatments, and care developments

Topics covered in Part 2:

1. EGIDs classification and nomenclature
2. Treat to Target in EoE: symptoms, histopathology and endoscopy goals
3. How treatments impact the quality of life for patients with EoE
4. Treatment options for EoE: Common questions from patients
5. Why are you treating me with an acid reducer if I have EoE? 
6. How effective are the topical corticosteroids, and what are the side effects? 
7. I heard this is a food allergy, and eliminating foods helps the disease? How effective is this and how does it work? 
8. I feel great after my therapy and dilation. Do I really need to stay on therapy? 
9. I am nervous about the esophageal dilation? Is it safe to do, and how do you dilate the esophagus? 
10. What causes EoE, and are there any new therapies? 
11. EoE Treatments algorithm - summary
12. Non-EoE EGIDs overview: classification by organs and digestive tract wall layers
13. The importance of Non-EoE EGIDs treatments on quality of life: fatigue, isolation, social, psychological, and financial impact and disease burden
14. Non-EoE EGIDs treatment overview: steroids, PPI, dietary therapy and other treatment approaches
15. Biologic therapy: trials on dupilumab (DEGA study), benralizumab, vedolizumab, and lirentelimab
16. Dietary interventions for Non-EoE EGIDs
17. Treatment options based on the severity of the disease
18. Non-EoE EGIDs Treatments Algorithm
19. Incidence and prevalence of EGIDs and overlap of Non-EoE EGIDs with EoE
20. Diagnostic delay of EGIDs
21. Clinical presentation of EGIDs by age: esophageal and non-specific symptoms in the esophagus and beyond
22. EoE and Non-EoE EGIDs Natural history: diagnostic delay, fibrostenosis and further complications during the clinical course in adults and children
23. Chronic nature of EGIDs: recurrence of EoE after treatment discontinuation, maintenance therapy (topical steroids)
24. Eosinophilic Colitis: the rarest of all EGIDs
25. Psychological conditions related to the burden of living with EGIDs
26. Atopy in EGIDs: asthma, allergic rhinitis, eczema, food allergies and other conditions
27. Associated autoimmune conditions in EGIDs: systemic lupus, rheumatoid arthritis, coeliac disease, and other disorders.
28. Future work: research on associated and co-existing conditions, personalised therapies, and the current research on EoG presentation, markers and risks identification.
29. EGIDs: It takes a village

Further Resources and Support:

Types of Eosinophilic Diseases

Biologics for Eosinophilic Diseases: Latest News & Research

Patient Stories: Meet People Living With Eosinophilic Diseases

EGIDS: Frequently Asked Questions

The Evolving Understanding of Eosinophilic-Associated Type 2 Inflammatory Diseases

This resource was developed with support from the National Lottery Community Fund.