Esinphilic Disrders Explained
Quick glance Esinphilic gastrintestinal disrders (EGIDs) are relatively new but their incidence is rising. EGIDs have n cure, but treatment is available. Generally children are diagnsed; hwever, the adult incidence is n the rise. Males are mre cmmnly affected than females. Esinphilic Esphagitis (E0E) is the mst cmmn EGID. EGIDs can be painful, and difficult t diagnse. Onging management is required. ausee prvides free infrmatin and supprt fr thse affected.
What is an esphagus and what des it d? The esphagus* is the rgan that cnnects the muth t the stmach. It is the way we get ur fd frm ur muths t ur stmachs. Think f it as a transprter f fd. *In Nrth America the spelling is esphagus.
What is an esinphil? An esinphil is a type f white bld cell that helps the bdy fight ff certain infectins and parasites. Nrmally esinphils d gd things.
Esinphils in the esphagus Smetimes the esinphils think that fd* is a freign invader (like a parasite) and they attack! This can make yu and yur esphagus feel very sick. It can cause inflammatin, irritatin, nausea, fd impactins, vmiting, stmach pains and a general feeling f being unwell. Smetimes it can make yu nt want t eat anything at all. *EE can als be triggered by aer-allergens such as grass, dust r pllen.
Hw d I knw if I have EE? The nly way t check whether esinphils are present in the esphagus is t perfrm an endscpy and take multiple bipsies f the esphagus. An endscpy is when a gastrenterlgist places a narrw tube with a camera dwn the patient s esphagus. A bipsy is when a very small sample f tissue is taken. The gastrenterlgist will nte hw the esphagus lks, as there may be furrwing (lines r ridges frm damage). Mst f the time, an endscpy is perfrmed as day surgery. The invasiveness f an endscpy is especially challenging fr children.
The diagnsis Once the bipsies are taken, a pathlgist reviews them under a micrscpe t see whether there are any esinphils. Generally, if mre than 15 per highpwer field are fund, active EE is diagnsed.
Esinphilic gastrintestinal disrders (EGIDs) Althugh EE is the mst diagnsed EGID, ther parts f the bdy can als be affected: Esinphilic gastritis: high numbers f esinphils in the stmach Esinphilic dudenitis: high numbers f esinphils in the dudenum Esinphilic enteritis: high numbers f esinphils in the small intestine Esinphilic clitis: high numbers f esinphils in the large intestine Esinphilic gastrenteritis: affects the stmach and small intestine.
PPI-REE diagnsis Prtn-pump inhibitr-respnsive esphageal esinphilia (PPI-REE r PPI-ROE) is a newly recgnized entity that must be differentiated frm EE. PPI-REE refers t patients with esphageal esinphilia n bipsy wh respnd t a curse f PPI therapy.
I ve been diagnsed with an EGID. What nw? Being diagnsed can be the end f a very lng jurney and the beginning f a new ne. It is very imprtant that yu wrk with yur gastrenterlgist, allergist and/r dietitian t find the best treatment plan fr yu r yur child. N tw cases are the same and there may be a time f trial and errr befre yu find what wrks best fr yu r yur child t relieve symptms. There will prbably be sme tests t determine if there is an allergic cmpnent. Once a treatment plan is in place, nging review is essential. It is just as imprtant t receive adequate supprt thrugh grups such as ausee and yur family and friends.
Allergy Testing Sme physicians may decide t send yu r yur child t an allergist. They may perfrm tests such as: Skin Prick Testing (SPT) Atpy patch testing RAST bld testing These tests may indicate if there is an immediate r delayed allergy. In EGID patients it is nt uncmmn fr allergy test results t be negative. Skin Prick Testing
What are sme cmmn treatment plans? An eliminatin diet* is ne treatment: This may mean excluding the eight mst allergenic fds, which are dairy, eggs, wheat, fish, peanuts, tree nuts, sy and shellfish. Sme treatment plans may eliminate less, sme mre. Each case is unique. If yu are nt eating enugh r nt receiving enugh nutritin frm yur fd, yu may be placed n an elemental frmula. This is a safe and effective way t maintain nutritin in thse wh have difficulty tlerating many fds. If a patient cannt tlerate any fds, an elemental diet may be required, which means eliminating all fds except fr an elemental frmula. *It is very imprtant that yu wrk with a qualified dietitian befre beginning any kind f eliminatin diet.
Other treatment ptins Sme patients may be prescribed a crticsterid medicatin. These are either sprays that are swallwed, r a liquid preparatin typically mixed with an artificial sweetener t make a slurry that is swallwed. Swallwing the medicatin cats the esphagus t help reduce the esinphil cunt. Unfrtunately, this treatment des nt wrk fr everyne. Other drugs (such as reflux medicatin) may als be prescribed.
Nutritin and tube feeding It is crucial t have a qualified nutritinist r dietitian t mnitr adequate nutritin levels. If thse levels are nt met, tube feeding, als called enteral nutritin, may be necessary. This is where fd in liquid frm is given thrugh a tube int the stmach r small intestine. The mst cmmn tubes are: a nasgastric tube (NG), which is put up the nse and dwn int the stmach a gastrstmy, smetimes called a PEG (percutaneus endscpic gastrstmy), which is placed in the stmach during a surgical prcedure. Sme PEGs have a tube always hanging ut and sme replacement PEGs are flat ( prfile r buttns ).
Living with an EGID It is imprtant t remember that n tw cases are the same. Each case will be treated differently. EGIDs are generally nt life threatening; rather, they are life limiting and can create scial challenges. This can affect many aspects f a family s life, s it is imprtant t get supprt r give supprt where yu can. Onging review with yur medical team is imprtant.
Online Supprt is Available We ffer an nline Facebk supprt frum that yu can jin here: www.facebk.cm/grups/ausee We als have a grup specifically fr Adults diagnsed with an EGID and it can be jined at: www.facebk.cm/grups/auseeadults The Official ausee Grup n Livewire can be jined by anyne aged between 10 t 20 wh is living with an EGID: www.livewire.rg.au
a charity dedicated t imprving lives affected by esinphilic disrders T find ut mre, please visit ur website at ausee Inc. ABN 30 563 569 016 Australia 2016 The infrmatin prvided in this publicatin is fr general infrmatin and supprt purpses nly and is nt intended as a substitute fr prfessinal medical advice frm yur dctr r ther health care prfessinal.