Questions to Ask Your Doctor

Here is a list of questions you may want to ask your doctor in regard to eosinophilic disorders.
 

Is this a primary disorder or is it secondary to something else?

 

For example, eosinophilic esophagitis is divided into primary or secondary. Primary eosinophilic esophagitis is further subclassified into idiopathic (unknown cause), atopic (allergic) or familial. Secondary eosinophilic esophagitis could be due to a more generalized eosinophilic disorder, such as eosinophilic gastroenteritis or hypereosinophilic syndrome or due to noneosinophilic disorders such as drug reactions, infections, gastroesophageal reflux, connective tissue disorders, vasculitis, leiomyomatosis, etc.
 

Where were the eosinophils found?

 

If the biopsies were obtained through esophagogastroduodenoscopy (EGD), it is important to know if the increased eosinophils were found only in the esophagus, in the stomach, in the duodenum or in all of them. If the esophagus is affected, it is also essential to know if it is only the upper or lower part of the esophagus or both the upper and lower parts of the esophagus that are affected. This information will help in decision-making (e.g. Is it eosinophilic esophagitis? Is it gastroesophageal reflux? Is it eosinophilic gastroenteritis?).
 

How many eosinophils where found?

 

More than 15 eosinophils per high power field (in the microscope) in esophageal biopsies is suggestive of primary eosinophilic esophagitis while less than 15 eosinophils per high power field (in the microscope) is associated with food allergies or gastroesophageal reflux.
 

Are there any food allergies?

 

A good percentage of patients with eosinophilic disorders of the gastrointestinal tract have food allergies. This possibility needs to be thoroughly evaluated by a doctor who is specialized in allergy and immunology.
 

What other conditions could cause the results in the biopsy?

 

Many disorders are associated with increased numbers in eosinophils in the gut. A complete history and physical exam plus associated tests should narrow the diagnosis.

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