Diagnosis

How is EGID diagnosed?

Endoscopy and biopsy is the ONLY way to confirm the diagnosis of EGID. It cannot be diagnosed based upon symptoms alone.

Endoscopy – a gastroenterologist performs an endoscopy by using an endoscope (a tube with a light and camera at the end) to look at the GI tract and take multiple small biopsies. Visually they may see rings or furrowing, thickened folds, microabcesses, white plaques, but even if the esophagus looks fine to the person performing the scope, the biopsies may still show an EGID.

 

Biopsy – the biopsies taken are later reviewed by a pathologist. A high number of eosinophils (counted per high power field under the microscope) suggest the diagnosis of EGID. The pathologist will also look for the location of the eosinophils (which part of the GI tract they are from & how deep in the tissue), changes in the layers of tissue, and degranulation (spilling of the contents of the eosinophils). Eosinophils can normally be found in small numbers in all areas of the GI tract except the esophagus. GERD (acid reflux) is associated with low numbers of eosinophils in the esophagus. With eosinophilic esophagitis, the number of eosinophils seen is much higher and remains elevated despite treatment with acid reflux medication.