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Eosinophilic Gastrointestinal Diseases

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					Eosinophilic Gastrointestinal
         Diseases

ICD-9 Coordination Committee Meeting
           Baltimore, MD
         September 28. 2007

         Glenn T. Furuta, MD
University of Colorado Medical School
   The Children’s Hospital, Denver
              Four points
• Eosinophilic Gastrointestinal Diseases
  (EGIDs) impact patient’s quality of life.

• Adults and children are affected by these
  chronic diseases with increasing frequency.

• Pathogenesis suggest role for allergy but
  still not certain; treatment limited to
  corticosteroids and dietary elimination

• Currently, borrowing from other diseases.
“ EGIDs impact patient’s quality of life”

            Definition-
     Consensus Statement 2007

  • Broad range of symptoms-often confused with
                   other diseases

 • Histology demonstrates increased eosinophils in
                  intestinal tissue
“ EGIDs impact patient’s quality of life”
      • Esophagitis- ?
         • Unresponsive GERD
         • Feeding problems / slow growth
         • Dysphagia and food impaction

      • Gastritis-?
         • Abdominal pain, bleeding, vomiting

      • Gastroenteritis and colitis-?
         • As above
         • Diarrhea
         • Swelling


      • Missed school and Work absenteeism
Eosinophilic
Esophagitis “530.13”
                           Eosinophilic Gastritis “535.41”




Eosinophilic Gastroenteritis / Enteritis “558.41”
Eosinophilic
Colitis “558.42”
“Adults and children are increasingly
             affected”

   • Recent studies identify
     both rise in incidence and recognition

   • Familial clustering

   • Genetic markers
  19




                    Publications
       78
            -1




                    0
                   10
                   20
                   30
                   40
                   50
                   60
                   70
               9
               9
            19 4
              9
            19 5
              9
            19 6
              97
            19
              98
            19
              99
            20
              0
            20 0



Year
              01
            20
              02
            20
                                   (1978-2007)




              03
            20
              0
            20 4
              0
            20 5
              0
            20 6
              07
                                                 EGIDs publications
“Pathogenesis suggest allergic role;
Treatment limited to corticosteroids
     and dietary elimination”

• IgE vs. Non IgE mediated

• Long term eosinophilic inflammation
  associated with fibrosis

• Food elimination and / or corticosteroids
  leads to improvement in many patients.
       Esophageal Stricture
Small caliber esophagus


                      Pre-endoscopy Post-endoscopy
“Borrowing from other
      diseases”

• Other eosinophilia / esophagitis
  288.3 / 530.1

• Allergic gastroenteritis 558.3
“Borrowing from other
      diseases”
• Track-epidemiology

• NIH-funding for research

• Therapeutic interventions
                Four points
• Eosinophilic Gastrointestinal Diseases (EGIDs)
  impact patient’s quality of life.

• Adults and children are affected by these chronic
  diseases with increasing frequency.

• Pathogenesis suggest role for allergy but still not
  certain; treatment limited to corticosteroids and
  dietary elimination

• Currently, borrowing from other diseases.

				
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posted:10/31/2011
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