What is Eosinophilic Gastroenteritis?

Eosinophilic gastroenteritis (EGE or EG) is rare gastrointestinal disease that can affect children and adults. The disease is characterized by the existence of abnormal gastrointestinal (GI) symptoms; frequently including abdominal pain and distension, nausea, vomiting and weight loss. Additionally, there's an eosinophilic infiltration that's present in at least one of the of the GI tract areas, the omission of eosinophilic participation in organs other than the GI tract and the lack of a recognized cause of eosinophilic. Symptoms of the disease can manifest in infancy although it often gets misdiagnosed.

Features

EG is a chronic condition where the symptoms can fluctuate. Symptoms that are sporadic and considered to be mild are usually manageable however, flare-ups of the disease can be disabling and require the use of oral corticosteroids. A person with EG has an irregular or scattered eosinophilic infiltration of their gastrointestinal tissue. The appearance of the condition can change depending on the extent and degree of the bowel wall involvement and precise location.

Types

A majority of patients with the disease have a history of severe food allergies. Depending on intensity and location, Eosinophilic gastroenteritis can be categorized into muscular, mucosal and serosal types. Symptoms such as vomiting, abdominal pain, problems with stool, malabsorption, iron deficiency anemia, protein-losing enteropathy are associated with the mucosal form. When there is a permeation of eosinophils (mainly in the muscularis layer) and GI obstructive symptoms are similar to those of other gastric ailments, it falls into the muscularis form. The least common variation of EG is the serosal form; characterized by substantial bloating and an increased secondary eosinophil count.

Identification

Eosinophilic gastroenteritis can be diagnosed through a number of ways. Imaging studies like ultrasounds, Computed Tomography scans (CT) and lab studies are used. A complete physical examination and patient history need to be taken. Blood tests including a CBC count and differential can identify and pinpoint variation of EG. Additional tests such as an endoscopy, colonoscopy and biopsy may be administered as well.

History

The precise history and exact cause of eosinophilic infiltration is unclear however, individuals who have EG also have increased levels of IgE and eosinophilia present in both the tissue and blood. Eosinophilic gastroenteritis was first described in the United States by Kaijser in the year 1937. Nearly 300 cases of the disease have been accounted for in different medical writings. The disease is considered to be most prevalent amid Caucasian males. Although chronic and debilitating, Eosinophilic gastroenteritis is not regarded as a terminal disease.

Prevention/Solution

The treatment of EG can consists of medications like Corticosteroids, GI workups, medical checkups and consultations and in some cases surgery. The surgical route is a last resort and usually only done on a patient who has obstruction in their small bowel. Dietary changes and education is very effective; as there is a significant correlation between those with the disease and an allergy to foods containing gluten and dairy.

Resources

• American Partnership for Eosinophilic Disorders (APFED)
• Eosinophilic Gastroenteritis