| EoE (esophagitis) | ≥ 15 (Normally absent) | Dysphagia, food impaction | Rings, furrows, white exudates (30% normal) | GERD: PPI-responsive, < 15 eosinophils/HPF, responds to acid suppression, lacks diffuse eosinophilia on biopsy. Infectious esophagitis (Candida/HSV): Immunocompromised, viral inclusions. Drug-induced: NSAID/antibiotic history. Achalasia: manometry abnormalities, minimal mucosal eosinophilia. Crohn’s disease of the esophagus: granulomas, transmural inflammation, systemic features.
| Topical steroids, diet elimination, and anti-IL-5 biologics |
| EoG (gastritis) | > 25–30 | Early satiety, vomiting, bloating | Thickened folds, antral ulcers, pseudo polyps (nonspecific) | H. pylori gastritis: + stool Ag/test, responds to antibiotics. Parasitic infections (strongyloides, etc.): ova/larvae in tissue or stool, travel history. Autoimmune gastritis: anti-parietal cell Ab+, achlorhydria. Gastric cancer: weight loss, lymphadenopathy. Ménétrier disease: hypoalbuminemia, foveolar hyperplasia. Gastric Crohn’s disease: granulomas, segmental involvement. Drug-induced gastritis (NSAIDs, antibiotics): temporal relation to medication, mixed inflammation.
| Corticosteroids, allergen-free diet |
| EoD (duodenitis) | ≥ 20 | Malabsorption, bloating, and anemia | Mucosal erythema, edema, nodularity, erosions (often normal) | Celiac disease: +tTG-IgA, villous atrophy, intraepithelial lymphocytes, anti-tTG positive. Tropical sprue: endemic region, megaloblastic anemia, partial villous blunting. Crohn’s disease: granulomas, ileal involvement, transmural changes, skip lesions, fecal calprotectin. Parasites (Giardia/Strongyloides): +Stool O&P, eosinophilia. NSAID enteropathy: medication history, systemic eosinophilia.
| Steroids, elemental diet |
| EoJ (jejunitis) | > 100 (Suggested) | Obstruction, ascites | Mucosal friability (deep disease: normal) | Crohn’s jejunitis: transmural inflammation, fistulae. Lymphoma: B-symptoms, monoclonal lymphocytes. Vasculitis (EGPA): asthma, ANCA+, neuropathy. Paraneoplastic syndrome: malignancy history. Parasitic infections (strongyloides, hookworm): stool/tissue organisms. Mastocytosis: mast cells (CD117+, tryptase+). Food protein–induced enteropathy: paediatric, resolves on elimination diet. Hypereosinophilic syndrome (HES): systemic eosinophilia (> 1,500/µL), multi-organ involvement.
| Immunosuppressants, surgery in case of obstruction |
| EoI (Ileitis) | > 30 | Right lower quadrant pain, diarrhea | Mucosal erythema, edema, friability, nodularity, strictures | Crohn’s ileitis: aphthous ulcers, transmural disease, granulomas, skip lesions. Infectious ileitis (Yersinia/TB): Fever, + PCR/culture. Appendicitis: acute RLQ pain, fever. Carcinoid tumor: 5-HIAA, mesenteric fibrosis. Tuberculosis (ileocecal TB): caseating granulomas, AFB positive, systemic features. Drug-induced enteritis (NSAIDs): ulceration, eosinophils with mixed inflammation. HES: systemic eosinophilia, cardiac/pulmonary involvement.
| Biologics, stricturoplasty |
| EoC (Colitis) | > 40 (Low specificity) | Diarrhea, malabsorption, eosinophilic ascites | Often normal (70%); patchy erythema | IBD (UC/Crohn’s): crypt distortion, chronicity, granulomas (Crohn’s). Parasitic colitis (schistosoma): travel history, ova in stool. Drug-induced (PPIs/NSAIDs): medication cessation resolves. Mastocytosis: +CD117, tryptase. Ischemic colitis: older age, vascular risk factors, segmental ischemic changes.
| Infant: watchful waiting. Adult: steroids |
