Eosinophilic gastroenteritis

Other Names: Eosinophilic gastritis; Eosinophilic enteritis; Eosinophilic gastroenteropathy; Eosinophilic esophagitis; EGE; Eosinophilic gastroenterocolitis

Eosinophilic gastroenteritis occurs when certain white blood cells known as eosinophils get into the digestive tract and cause damage.

Epidemiology

It has been estimated that about 8.4-28 people per 100,000 have eosinophilic gastroenteritis in the United States. There have been about 300 cases reported in the medical literature.

Cause

The exact cause of eosinophilic gastroenteritis is unknown. It is thought that an abnormal immune reaction to a food allergy, along with genetic factors, may contribute to the development of this condition.

Riskfactors

EoE can affect anyone, but it is more common in people who

• Are male
• Are Caucasian
• Have other allergic diseases, such as hay fever, eczema, asthma and food allergies
• Have family members with EoE

Signs and symptoms

The following list includes the most common signs and symptoms in people with eosinophilic gasteroenteritis. These features may be different from person to person. Some people may have more symptoms than others and symptoms can range from mild to severe. This list does not include every symptom or feature that has been described in this condition.

Symptoms of eosinophilic gastroenteritis may include:

• Stomach pain
• Diarrhea
• Nausea and vomiting
• Inability to absorb nutrients from food (malabsorption)
• Weight loss
• Intestinal obstruction

Symptoms can occur at any age but they usually develop between ages 30 and 50. Children with eosinophilic gastroenteritis may have problems with growth due to malabsorption. In general, symptoms tend to occur periodically, and may go away completely with treatment.

For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. 80%-99% of people have these symptoms

• Eosinophilia(High blood eosinophil count)

30%-79% of people have these symptoms

• Abdominal pain(Pain in stomach)
• Allergic rhinitis(Hay fever)
• Anemia(Low number of red blood cells or hemoglobin)
• Dysphagia(Poor swallowing)
• Elevated C-reactive protein level
• Hypoalbuminemia(Low blood albumin)
• Steatorrhea(Fat in feces)
• Vomiting(Throwing up)

5%-29% of people have these symptoms

• Ascites(Accumulation of fluid in the abdomen)
• Asthma
• Atopic dermatitis
• Edema(Fluid retention)
• Elevated erythrocyte sedimentation rate(High ESR)
• Hematochezia(Rectal bleeding)
• Protein-losing enteropathy
• Weight loss

Diagnosis

Diagnosis of eosinophilic gastroenteritis is based on the symptoms, clinical exam, laboratory tests, and imaging studies. Laboratory tests may include blood tests for immunoglobulins, red and white blood cell levels, and infections. Imaging studies may include a CT scan and an endoscopy to look at the stomach and intestines. It may also be necessary to do a take a small piece of tissue from the intestine to exam under the microscope (biopsy). It is often necessary to exclude other more conditions before diagnosing eosinophilic gastroenteritis.

Treatment

There is no cure for EoE. Treatments can manage your symptoms and prevent further damage. The two main types of treatments are medicines and diet.

Medicines used to treat EoE are Steroids, which can help control inflammation. These are usually topical steroids, which you swallow either from an inhaler or as a liquid. Sometimes doctors prescribe oral steroids (pills) to treat people who have serious swallowing problems or weight loss. Acid suppressors such as proton pump inhibitors (PPIs), which may help with reflux symptoms and decrease inflammation.

Dietary changes for EoE include Elimination diet. If you are on an elimination diet, you stop eating and drinking certain foods and beverages for several weeks. If you are feeling better, you add the foods back to your diet one at a time. You have repeat endoscopies to see whether or not you are tolerating those foods. There are different types of elimination diets: With one type, you first have an allergy test. Then you stop eating and drinking the foods you are allergic to. For another type, you eliminate foods and drinks that commonly cause allergies, such as dairy products, egg, wheat, soy, peanuts, tree nuts and fish/shellfish.

Elemental diet. With this diet, you stop eating and drinking all proteins. Instead, you drink an amino acid formula. Some people who do not like the taste of the formula use a feeding tube instead. If your symptoms and inflammation go away completely, you may be able to try adding foods back one at a time, to see whether you can tolerate them.

Which treatment your health care provider suggests depends on different factors, including your age. Some people may use more than one kind of treatment. Researchers are still trying to understand EoE and how best to treat it. If your treatment is not working well enough and you have narrowing of the esophagus, you may need dilation. This is a procedure to stretch the esophagus. This makes it easier for you to swallow.

NIH genetic and rare disease info

• NIH info on Eosinophilic gastroenteritis

Eosinophilic gastroenteritis is a rare disease.

Eosinophilic gastroenteritis Resources
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