The experts in the Eosinophilic Gastrointestinal Disease Program at Boston Children’s Hospital understand the challenges for kids living with an allergic gastrointestinal disease. Our specialists have the knowledge, experience, and compassion to treat infants, children, and teenagers with these lifelong conditions. As a leader in the diagnosis, treatment, and research of pediatric eosinophilic gastrointestinal disorders (EGIDs), our program provides comprehensive care for patients from across the U.S. and around the world.
What are eosinophilic gastrointestinal disorders (EGIDs)?
EGIDs are a group of diseases caused by a buildup of eosinophils in the lining of the gastrointestinal (GI) tract. An eosinophil is a type of white blood cell that is usually triggered by an allergic reaction. The buildup of eosinophils in the GI tract can lead to uncomfortable symptoms such as swallowing problems, vomiting, belly pain, poor appetite, acid reflux, diarrhea, and poor growth.
There are several different types of EGIDs. The type depends on where in the GI tract the eosinophils have built up.
- Eosinophilic esophagitis (EoE): This is the most common EGID. It occurs when the lining of the esophagus has become irritated from a buildup of eosinophils.
- Eosinophilic gastritis (EG): This type occurs when there are eosinophils in the stomach lining.
- Eosinophilic gastroenteritis (EGE): This type occurs when there are eosinophils in both the stomach and the small intestine.
- Eosinophilic colitis (EC): This type occurs when the eosinophils are in the lining of the large intestine.
Our clinicians also have expertise in other rare allergic gastrointestinal disorders, such as:
- Mast cell activation disorders: In mast cell activation disorders, your body’s mast cells release too much of the chemical histamine, causing symptoms such as hives, swelling, stomach aches, and wheezing.
- Systemic mastocytosis. This is a very rare disease in which your body makes extra mast cells. The spleen, liver, gut, and skin have a buildup of mast cells, which if triggered can make you feel very sick.
- Food protein-induced enterocolitis syndrome (FPIES). This rare food allergy mostly affects young babies and children, who tend to outgrow it by age 3 or 4. Signs and symptoms of FPIES include: vomiting, diarrhea, dehydration, lethargy, and poor growth. Milk and soy are the most common triggers for an FPIES reaction. Other common food triggers include oats, rice, poultry, peas, and squash.
- Alpha gal allergy. This is an allergy to alpha galactose, a sugar present in most animal cells. It is thought to occur after a tick bite. The reaction can occur up to eight hours after eating meat (beef, pork, lamb, venison, rabbit). Symptoms include hives, rashes, nausea, vomiting, and abdominal pain.
- Collagenous gastritis. This is a very rare disease in which a band of collagen builds up in the lining of the stomach. Symptoms include abdominal pain, anemia, diarrhea, nausea, vomiting, and weight loss.
How we care for children and teens with EGIDs and other allergic GI disorders
Every child with an EGID is unique. In the Eosinophilic Gastrointestinal Disease Program, we tailor our care plan depending on the type and severity of your child’s diagnosis. We offer specialized, comprehensive treatment for EGIDs, including medications and food elimination diets. If needed, we also provide medical procedures like interventional endoscopy and dilation. We work closely with families to determine the best options for medication and dietary changes, depending on the child’s needs and the family’s preferences. We understand that you know your child best, so it’s important to our team that you be involved in all decisions regarding your child’s treatment plan.
Our goal is to improve the quality of life for patients and families affected by EGIDs. We offer:
- complete evaluation for kids who have been diagnosed with an EGID
- diagnostic testing including blood work, endoscopy, allergy testing, and radiology testing
- nutrition evaluation and dietary guidance by a dietitian with expertise in food allergies and GI disorders
- education and support for the patient and family
- school/camp advocacy to help you educate your child’s teachers and caregivers
- follow-up care via phone, in-person appointments and, in some circumstances, telemedicine
- assistance coordinating appointments for families traveling out of state to our hospital in Boston
A team approach to EGIDs
Treating children with EGIDs requires close communication with several different types of specialists. The pediatric specialists in the Eosinophilic Gastrointestinal Disease Program have advanced training and experience both in their field and in caring for children. Having a team of these experts gives your child the best and most complete care possible. Our highly team includes:
- board-certified pediatric gastroenterologists that specialize in EGIDs, who assess the GI tract, treat GI symptoms, and monitor growth
- board-certified pediatric allergists that specialize in EGIDs, who identify specific food triggers that could be causing the EGID and optimize all other allergic conditions that could be stimulating the immune system
- occupational and speech therapists who specialize in feeding problems associated with EGIDs
- psychologists who support patients throughout diagnosis, treatment, and lifestyle changes for these conditions
- registered dietitians who assess your child’s nutrition, make a specific diet plan for your child, and help families ensure their children are getting enough nutrients, even on a restricted diet
- social workers who ensure that you and your child have the resources you need at home and at school to be successful at implementing the treatment plan
- child life experts who can help your child feel more comfortable in the hospital setting and support them throughout procedures