Eosinophilic Gastrointestinal Disease Program | Your Visit

The Eosinophilic Gastrointestinal Disease Program sees patients in our outpatient clinics in both our main hospital in Boston and our satellite clinic in Waltham.

Please share the following with us in advance of your visit:

• Pathology slides
• Radiology test results, if any
• Results of any endoscopic procedures
• Allergy test results, if any
• Recent gastroenterology and allergy clinic notes

Our preference is to have these documents faxed to 617-730-0496 marked “Attn: EGID.” If records are too large to be faxed, please mail them to:

Boston Children's Hospital EGID program
300 Longwood Ave. — Hunnewell Ground Floor
Boston, MA 02115

If it's your first visit, you should expect to be with us for about three hours. Return visits are usually shorter.

Children visiting the clinic typically meet with a number of specialists, such as:

• Gastroenterologist: Our gastroenterologist will examine your child, review your child's medical history with you, and answer any questions you may have. They may recommend additional tests, such as an endoscopy or radiology study.
• Allergist: Our allergist will meet with you, examine your child, and may also recommend testing, such as skin or blood tests.
• Dietitian: We understand the frustration of restricting your child's diet due to food allergies. Our dietitian will meet with you and offer the tools needed to eat healthy and avoid allergic reactions.
• Social worker: Our social worker can provide coping support, connect you with the EGID community locally and nationally, introduce you to support groups, and help you advocate for your child.
• Clinical coordinator: As your primary contact person, your clinical coordinator will facilitate communication with your child's treatment team, coordinate your child's care, and schedule appointments.

All of our doctors and staff work hard to see each child on schedule and to make their visit as comfortable as possible.

Tests may include:

• Endoscopy. Children with eosinophilic esophagitis (EoE) require multiple upper endoscopies to monitor the inflammation and damage to the esophagus. We offer transnasal endoscopy, a novel approach in which a very small camera is inserted through the nose down into the esophagus to capture photographs and samples of the tissue. No anesthesia is required and the entire procedure takes less than 20 minutes. Your child’s physician will determine their eligibility for transnasal endoscopy.
• Barium imaging: In this test, your child drinks a preparation containing barium, a liquid that shows up on X-ray. An X-ray is then taken of your child's esophagus, stomach, and small intestine.
• Allergy testing
  • Skin prick tests apply a drop of the suspected allergen on the surface of your child's skin. A positive test can be seen within 15 to 20 minutes, with hives and redness at the test site. However, a positive test doesn't always mean your child is allergic to that allergen. The test isn't considered painful, but positive reactions can cause itching. You may be asked to have your child avoid certain medications before the testing, as they may interfere with the results.
  • Blood tests, also known as RAST tests, measure the IgE antibodies your child produces in response to allergens. They may be used when skin tests cannot be performed. Again, a positive test doesn't always mean your child is allergic to that allergen, and doesn't predict the severity or the type of reaction. But it does give information on the likelihood of having a reaction if exposed to that allergen.
  • Food patch tests can detect delayed-reaction food allergies. They require two separate visits to the Allergy and Asthma Program. On the first visit, a food patch test panel is placed on your child's back, secured with tape. The panels consist of prepared foods selected by your allergist, placed on shallow aluminum disks.

If your child is taking medications containing antihistamines, it is important that you follow these directions:

• Stop the following medications seven to 10 days before your visit: Allegra (fexoferadine), Claritin (loratadine), Clarinex, Clemastine, Tavist, Atarax (hydroxyzine) and cyproheptadine (Periactin).
• If your child is taking Zyrtec, stop it 10 to 14 days before your visit.
• At least three days before the visit, stop non-prescription cold or allergy medicines containing antihistamines, including Benadryl (diphenhydramine), Actifed, Dimetapp, Pediacare, and Triaminic cold formulas.

If you do not know whether your child's medicine contains antihistamines, or are concerned about stopping a medication, ask the pharmacist or call the Boston Children's Allergy and Asthma Program at 844-917-2439 and ask to speak with a nurse.

On the day of the visit, do not use asthma medications (bronchodilators) such as albuterol, Ventolin, Proventil, Xopenex, or Maxair unless your child is coughing or wheezing. Other asthma medications and antibiotics should be given as usual.

Do not stop any other medications prescribed by your doctor.