March 12, 2018
Years published: 1989, 1999, 2005, 2009, 2012, 2015, 2018
NORD gratefully acknowledges Adriaan Tan, MD, Hepatogastroenterologist, Canisius Wilhelmina Hospital, The Netherlands, for assistance in the preparation of this report.
Eosinophilic gastroenteritis is a rare digestive disease characterized by the triad of eosinophilic infiltration of segments of the gastrointestinal tract, abnormalities of gastrointestinal function (varying from dyspepsia and obstruction to diarrhea and ascites) and exclusion of other diseases with peripheral eosinophilia. Eosinophilic esophagitis is increasingly being recognized and is not included in this report.
Eosinophilic gastroenteritis may affect any part of the gastrointestinal tract from the esophagus to the rectum. Symptoms include dysphagia (sometimes presenting as food impaction), heartburn, abdominal pain, nausea, vomiting, diarrhea, weight loss, and bloating (ascites is possible). The eosinophilic infiltration may involve one or more layers of the gastrointestinal wall. The particular symptoms present in each person depend upon the layer and the location of involvement. Most commonly, the stomach wall and the small bowel are involved. Mucosal involvement leads to protein-losing enteropathy and malabsorption. Muscle layer involvement causes abdominal pain, vomiting, dyspeptic symptoms and bowel obstruction. Subserosal involvement predominantly causes ascites with marked eosinophilia. Sometimes eosinophilic pleural effusion is present. Eosinophilic gastroenteritis is a chronic, waxing and waning condition.
The exact cause of eosinophilic gastroenteritis is unknown. Some cases of this disease may be caused by a hypersensitivity to certain foods or other unknown allergens. Often, a family history of allergy is present. Atopy (asthma, hay fever or eczema) is present in a subset of patients. Food allergies are common.
Eosinophilic gastroenteritis is a rare disease (10/100.000) that affects both males and females, but is slightly more common among men. Peak prevalence is in children and adults 20-50 years of age. The reported prevalence has increased markedly, and this is probably due to prior under-diagnosis. People with a history of allergies, eczema, and seasonal asthma are more likely to develop this disease.
Some patients present with elevated IgE and eosinophilia of tissue and blood. A careful history may suggest to the physician that a biopsy is required. The results of the biopsy (endoscopic or full-thickness surgical biopsy) are usually diagnostic.
Eliminating foods to which a person is allergic may prove helpful in some cases. The corticosteroid drug prednisone is usually an effective treatment for eosinophilic gastroenteritis. Sometimes budesonide can be helpful. Immunosuppressive drugs like azathioprine may be worth trying. Surgery may be necessary in severe cases in which there is an obstruction of the intestines. Other treatment is symptomatic and supportive.
Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. Government funding, and some supported by private industry, are posted on this government web site.
For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:
Tollfree: (800) 411-1222
TTY: (866) 411-1010
Some current clinical trials also are posted on the following page on the NORD website:
For information about clinical trials sponsored by private sources, contact:
For information about clinical trials conducted in Europe, contact:
The National Institute of Allergy and Infectious Diseases (NIAID) of the NIH is conducting a clinical research study involving people with eosinophilic gastroenteritis. The study seeks to investigate omalizumab as a possible treatment for people with this disorder. For information, contact the NIH Patient Recruitment Office listed above.
Zhang M, Li Y. Eosinophilic gastroenteritis: A state-of-the-art review. J Gastroenterology and Hepatology 2017;32:64–72
Rached A, Hajj W. Eosinophilic gastroenteritis: Approach to diagnosis and management. World J Gastrointest Pharmacol Ther 2016;7:513-523
Collins MH. Histopathologic features of eosinophilic esophagitis and eosinophilic gastrointestinal diseases. Gastroenterol Clin N Am 2014:43:257-268
Abdulrahman AA. Storr MA. Shaff EA.Eosinophilic colitis: an update on pathophysiology and treatment. British Medical Bulletin 2011; 100: 59–72.
Nguyen MN T, Szpakowski J-L. Eosinophilic Gastroenteritis. Medscape. Updated Jan 11, 2017. http://emedicine.medscape.com/article/174100-overview Accessed March 7, 2018.
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