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Enteroscopy results

I recently had a colonoscopy and enteroscopy for my previously diagnosed Crohn's disease. Test went fine, no problems. They put me out! (God bless diprivan) Anyway, I got my biopsy results today. The good news is most of the biopsies were clear of crohn's and no scarring. Yay again. But, on my upper scope, the found some eosinophils and asked if I have any heartburn or reflux problems. Occasionally I do, but not enough to really mention. Which is what I told her. I am now on a trial of a proton pump inhibitor for 3 months. When I googled eosinophils and egd, I get all this info on eosinophilic gastritis. Has anyone ever had eosinophils found on an upper scope? Nothing to worry about or so etching to question my physician on more when I see him next?
 
Location
San Diego
Eosinophilic gastritis is a form of allergy, usually a food allergy. But a proton pump inhibitor is more of a treatment for acid reflux rather than an allergy. So it looks like they are treating the symptoms (heartburn) rather than the suspected cause (eosinophilic gastritis). Maybe the eosinophils are only mildly elevated and not worth the side effects of hammering them down with a fierce anti-allergy drug like say prednisone.

I guess you can clarify all this with your GI on your next visit.
 

my little penguin

Moderator
Staff member
The new guidelines lines from apfed and other egids (eosinophilic Gastro intestinal disease)
Use of a high dose protein pump inhibitor(ppi) has been effective in some at lower true EoE or E.G. -borderline EoE around 15 EOS per high power field
When the Eos (eosinophils) are low in number

Most GI recommend high dose ppi for 6-8 weeks and Rescope


For kids the options after ruling out the ppi isn't effective
Are six food allergen elimination diet (basically top eight food allergens
Milk wheat soy peanuts/treenuts eggs fish/shellfish)
If that doesn't work patch skin testing and Ige testing
Most children that don't clear on top eight diet
Use elemental formula only and introduce 1-3 foods for 8-12 weeks and rescope
Until a significant diet is established


Other option is swallowed Flovent /slurry
(Flovent is typically inhaled for asthma ) in EoE its swallowed to coat the esophagus
This can be done without any diet changes and after 8-12 weeks rescope to determine effectiveness


If the top 8 allergen diet or swallowed flovent is not effective some kids do both
To avoid elemental formula


Most adults start with swallowed Flovent since adults typically have a harder time adjusting their diet


EoE can cause thickening and furrowing of the esophagus
E.G. Is lower in the stomach and EC is near the rectum


They are a mixed Ige disorder

Helpful links

http://apfed.org/resources/for-patients/for-adults/

EoE is defined as an immune-mediated clinicopathologic condition characterized by esophageal dysfunction and eosinophil-predominant inflammation. This new conceptual definition has been proposed partly due to a recently identified disease phenotype called “PPI-responsive esophageal eosinophilia”. Emerging data support the possibility that this condition represents a clinical response to anti-inflammatory properties of PPIs that are independent of effects on gastric acid.

From
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4118554/


https://gi.org/guideline/evidenced-...osinophilia-and-eosinophilic-esophagitis-eoe/


https://www.jscimedcentral.com/Pedi...pediatric-gastroenterology-disorders-1040.pdf



A group to talk to other moms of kids with egids and adults who have the disease

https://community.kidswithfoodallergies.org/forum/gastrointestinal-disorders



More links
https://community.kidswithfoodaller...esources-egid-celiac-crohn-s-fpies-and-gerd-1


Hope that helps
 

my little penguin

Moderator
Staff member
Please ask for a copy of the pathology report and send the slides out for a second opinion
Eosinophils are increased in Crohns
So when the numbers are slightly above the norm they can be a secondary eosinophilia
Since Crohns can cause an increase
Egids are only considered if there isn't a primary cause

So the waters get very muddy quick with a Crohns dx

There are few adults GI places familiar with egids

Cincinnati children's will review adults records for egids

I think National Jewish in Denver co will as well

You will need a GI who is well versed in egids
Since the disease is very new and newer in adults
 
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