Results and what they mean...

We had a busy day yesterday and today! Yesterday, Henry had an ultrasound to check his pancreas in response to the pancreatic nodule observed during the endoscopy. Everything looked good and there are no concerns.

Today, in addition to feeding therapy, we had an appointment with the allergist. The allergist was wonderful and actually has a very similar story to ours… her daughter was born at 34 weeks, had cows milk and soy allergies, and feeding difficulties. It was nice to talk to someone in the medical field who understands and has experienced some of what we are going through. The allergist told us Henry has Eosinophilic Gastritis. Eosinophils are white blood cells that are typically produced in response to a parasitic infection. Eosinophils gather in the area of the infection and release toxic granules that destroy parasites. When produced in response to an allergy, the granules can be damaging to the lining of the esophagus, stomach, and/or intestines causing tissue damage and ulcers. Fortunately, Henry’s esophagus, stomach, and upper intestines appeared healthy and normal during the endoscopy, indicating that the eosinophils have not caused any significant damage.

The allergist told us Eosinophilic Gastrointestinal Disorders (EGID) are somewhat “new” and that there is a lot of research occurring as to why and when they occur. There is not a test to identify what causes the body to produce eosinophils. Doctors rely on allergy tests, although allergy testing identifies substances that cause a histamine reaction, and not necessarily an eosinophilic reaction. Since Henry has a histamine response to cows milk allergy it is thought that it is also causing his eosinophilic response.

We also had Henry tested for seasonal allergies, since what you breath can also be ingested. The testing showed that Henry has an allergy to dogs. Fortunately, the reaction was not significant, so we will try to reduce his exposure.

To treat Henry’s EGID, we will give him Pulmicort, a steroid, for 6-8 weeks. The “good” news is that exposure to dogs and/or minor amounts of milk proteins will not aggravate his EGID during the treatment. There were a few high calorie foods we were giving him where milk proteins were low on the ingredient list. The allergist told us we could continue giving these to “buy time” to help put weight on while the Pulmicort eliminates the eosinophils.

We are hoping that the Pulmicort will help Henry feel more comfortable and make him want to eat more. In a few days, we will start trying Periactin, which is an appetite stimulant. We are hoping that with the Prevacid, Pulmicort, and Periactin that Henry really starts eating well and gaining good weight. After the treatment with Pulmicort, we will talk with the doctors to determine if another endoscopy is warranted. The only way to confirm the elimination of eosinophils from Henry’s stomach is to perform an endoscopy.