Patient: [Patient Name]
MRN: [Medical Record Number]
Date: [Date of Encounter]
Chief Complaint:
(Varies depending on the affected GI tract and severity)
Abdominal pain (cramping, chronic, episodic)
Nausea and vomiting
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Diarrhea (may be bloody)
Difficulty swallowing (if esophageal involvement)
Rectal bleeding
Malnutrition (weight loss, growth failure in children)
History of Present Illness:
Onset, duration, and character of any gastrointestinal symptoms.
Frequency and severity of symptoms (e.g., daily diarrhea, intermittent
abdominal pain).
Passage of blood in the stool (bright red blood suggests lower gastrointestinal bleeding).
Vomiting (frequency, content – bloody, bilious).
Difficulty swallowing (present/absent, severity).
Change in bowel habits (constipation, urgency).
Appetite changes (loss of appetite, increased hunger).
Weight loss (intentional or unintentional).
Prior episodes of similar symptoms (relapsing-remitting course).
Past Medical History:
Underlying medical conditions (e.g., allergies, atopy, inflammatory bowel disease (IBD)).
Prior surgeries (abdominal surgeries may increase risk of certain NE-EGIDs).
Social History:
Dietary habits (food allergies, intake of potential triggers).
Travel history (exposure to endemic parasites for eosinophilic gastroenteritis).
Smoking history (smoking may worsen symptoms).
Use of medications or supplements (potential for drug-induced eosinophilia).
Family History:
Family history of atopy, allergies, or inflammatory bowel disease.
Physical Exam:
General examination: Assess for signs of malnutrition (weight loss, muscle wasting), fever (suggestive of active inflammation).
Abdominal examination: Palpate for abdominal tenderness, masses, ascites (fluid accumulation).
Laboratory Tests:
Complete blood count (CBC): May show eosinophilia (increased eosinophils) in some cases.
Serum electrolytes: May be deranged if there is significant diarrhea or malnutrition.
Stool tests:
Stool occult blood: May be positive if there is bleeding in the gastrointestinal tract.
Ova and Parasites (O&P) exam: To rule out parasitic infections
(eosinophilic gastroenteritis).
Fecal Leukocyte Test: May be elevated in inflammatory bowel disease (can mimic NE-EGID).
Allergy testing (skin prick or specific IgE): May identify potential food allergies that could be contributing factors.
Autoimmune serologies: To rule out autoimmune conditions (eosinophilic colitis may overlap with ulcerative colitis).
Imaging Studies:
Abdominal X-ray or ultrasound (limited role): May be used initially to rule out other causes of symptoms (e.g., bowel obstruction).
(More specific imaging based on suspected location and severity):
Upper endoscopy with biopsy: To evaluate the esophagus, stomach, and duodenum for eosinophilic infiltration.
Capsule endoscopy (for small bowel involvement): Visualizes the
entire small intestine.
Colonoscopy with biopsy: To evaluate the colon and rectum for
eosinophilic infiltration.
Pathology:
Microscopic examination of biopsy specimens from the gastrointestinal tract is essential for diagnosis. Biopsy should demonstrate increased eosinophils in the tissue.
Assessment:
Non-esophageal eosinophilic gastrointestinal disorder (NE-EGID):
Suspected based on clinical presentation (symptoms suggestive of gastrointestinal involvement), and confirmed by eosinophilia on biopsy from the affected GI tract.
Specific site of involvement: Eosinophilic esophagitis (EoE) is excluded by definition, so the location needs to be determined (e.g., eosinophilic gastritis, eosinophilic gastroenteritis, eosinophilic colitis).
Severity of disease: Based on symptom burden, frequency, and
complications (e.g., malnutrition, strictures)