Treatment

Once you have a confirmed diagnosis, the consultant will discuss treatment options. There is NO cure for EGID, however dietary measures and/or medications can help. The best course of treatment will depend on the patient. The consultant should discuss these with you. There are 3 main courses of action that may be followed, each is outlined below. As you will see from the links on this page, there are no articles directly linked to EGID treatment. Another reason why public awareness must be raised on this issue.

All information provided on this page is as a guide only. In no way should it be used to replace any professional medical advice:

Elimination Diet

It is thought that EGID is associated with allergies. In the USA the first course of action for an EGID patient would be allergy testing. This is done by carrying out a series of tests such as skin prick testing and patch testing. In the UK however allergy testing can be very difficult to get done, NHS waiting lists are very long. Because of this, you are more likely to be given a RAST (radioallergosorbent) test. This is a blood test used to investigate allergies to a variety of food groups, mites and animal dander. A positive result to a food will result in that food being eliminated from the diet, hence the name. Depending on the results, an elimination diet may or may not be recommended. Allergy testing can never be 100% correct, a false negative (allergy not detected on testing) can lead to the failure of an elimination diet. There are many stockists of dietary foods and some good books with advice and recipes. Some of these are listed on our links page

Elemental Diet

Sometimes a stricter diet may need to be followed, in this instance an elemental diet may be introduced. Elemental diet means NO whole protein, whole carbohydrate or whole fat is allowed. Special formulas are made of amino acids (the building blocks for proteins), fatty acids, simple sugars, vitamins and minerals. Amino acids should not (although nothing is 100%) cause an allergic reaction as a whole or part protein would. In the UK the most likely formulas to be offered are Neocate LCP, Nutramigen AA and Elemental EO28 (All are cows milk free). Formula's such as Nutramigen 1 and 2 still contain partial proteins and can trigger a reaction (they are made from extensively hydrolysed cow's milk)

Elemental diets can be offered in conjunction with elimination diets and/or medication or as the sole treatment. Some patients who require an elemental diet for a long period may require a feeding tube to be inserted into the stomach to get adequate calories and nutrition. Insertion of a tube is rare in the UK and usually used as a last resort. More details on feeding tubes are available through the PINNT website, a link is on the left of this page.

It is essential that you see a dietician who will help you with the management of your elemental diet. Sometimes just removing milk, egg, wheat and soya is enough to control the symptoms. Your specialist will help you plan a nutritionally adequate diet, also a dietician can provide information on recipes, available free from foods and resources.

Medication

There are no medications to cure eosinophilic disorders. Medication can be used to suppress the eosinophils in the gastrointestinal tract and relieve symptoms of the disease. Not all forms of EGID respond to the same treatments and different people with the same type may need very different medications.

Medications which have been used in the treatment of EGID are listed below. There is little published medical evidence in the UK of the benefits of any of these treatments, although there is some limited ongoing research:

Glucocorticoids (Steroids) - used to suppress various types of inflammation. These are not specific to treat EGID although eosinophils have been known to be particularly sensitive to them. The most common of these is Prednisolone. Initially a high dosage will be given and then reduced over time to the lowest point where no adverse reaction is noted.

Leukotriene (luke-o-try-een) Inhibitors - These are used to improve the symptoms in patients but do not necessarily improve the eosinophil count. The most common of these used in the UK is Montelukast (Singulair). As you can see from the link, this drug is used primarily in Asthma, it is known to relieve symptoms in other Allergic conditions.

Sodium cromoglicate - This drug is widely use to treat food allergies and most commonly used in the UK under the trade name of nalcrom.

Amino-salicylates - These are used in the treatment of inflammatory bowel disease (IBD), Crohns disease and Ulcerative Colitis (UC). They are anti-inflammatory drugs and usually given in liquid form called Sulphfasalazine.

Anti-histamine - Anti-histamine drugs are already used extensively in allergic diseases such as Asthma and Eczema. In the treatment of EGID, examples of those used are Zirtek (Cetirizine) and Zaditen (also known as Ketotifen). There is currently an issue with sourcing the tablet version and we are trying to get clarification of future availability.

Immunosuppressants - These are used to reduce the activity of cells in the immune system, they are used to enable a reduction in steroid dose and maintain remission in patients. They are very powerful and have only been used in severe cases. There are numerous side affects associated with these, and need to be monitored very closely. Examples of those used are Azathioprine and Cyclosporin.

Other Medications - Patients with EGID commonly have other associated illnesses such as; Gastroeosophageal reflux disease (GERD), gastroparesis (delayed emptying of the stomach), eczema, asthma and other environmental/seasonal allergies. Some of the drugs shown above can be used to treat these associated problems. The treatment of other allergic problems is important in the control of EGID.