Eosinophilic gastroenteritis (EGE) is a rare digestive disorder where white blood cells called eosinophils build up in your stomach and intestines. This buildup causes inflammation and can lead to various uncomfortable symptoms. Understanding this condition can help you recognize symptoms early and work with your healthcare provider to find the right treatment.

What Is Eosinophilic Gastroenteritis?

Eosinophilic gastroenteritis belongs to a group of conditions called eosinophilic gastrointestinal diseases (EGIDs). These conditions occur when eosinophils, which normally help fight infections and parasites, accumulate in parts of your digestive system where they don’t belong.

EGE specifically affects the stomach and small intestine. It’s different from eosinophilic esophagitis (EoE), which affects only the esophagus, though both conditions involve similar inflammatory processes (1).

Symptoms of Eosinophilic Gastroenteritis

Symptoms can vary depending on which layer of your digestive tract is affected. People with EGE often experience gastrointestinal symptoms that can be unspecific and easily confused with other conditions.

Common Symptoms

The most frequent symptoms include:

  • Abdominal pain
  • Nausea and vomiting
  • Diarrhea
  • Weight loss
  • Bloating

These symptoms were noted in a systematic review of 20 cases where EGE was associated with autoimmune conditions. The review found that gastrointestinal symptoms were often unspecific (2).

Less Common Presentations

In some cases, EGE can cause more serious complications. When it affects the pancreas, it may lead to pancreatitis. A systematic review found no significant difference in symptoms between people with eosinophilic pancreatitis and those with pancreatitis associated with eosinophilic gastroenteritis (3).

Note
Many people with EGE have elevated eosinophil counts in their blood tests. About 67% of cases show this finding, which can be an important clue for diagnosis.

Who Gets Eosinophilic Gastroenteritis?

EGE can affect people of all ages, but certain groups may be at higher risk.

Association with Other Conditions

EGE often occurs alongside other health conditions. Research shows important connections with:

Autoimmune Diseases: Among people with both EGE and autoimmune conditions, systemic lupus erythematosus is the most common (35%), followed by rheumatoid arthritis (20%), and systemic sclerosis or inflammatory myopathies (15% each) (2).

Autism Spectrum Disorder: Recent research suggests there may be a connection between EGIDs and autism spectrum disorder (ASD). A meta-analysis indicates that both conditions might be related to problems with the intestinal barrier (4).

Allergies: Unlike eosinophilic esophagitis, where allergies are common, most people with EGE associated with autoimmune diseases don’t have a history of allergies (2).

Racial Differences

Research has shown differences in how eosinophilic gastrointestinal disorders affect different racial groups. A systematic review of 2,621 patients found variations in presentation between Caucasians and Asians (5).

Diagnosis Challenges

Diagnosing EGE can be challenging because its symptoms overlap with many other digestive conditions.

Endoscopy Findings

When doctors perform endoscopy (a procedure to look inside your digestive tract), they may not always see abnormal findings. In fact, upper endoscopy shows abnormal findings in only 40% of cases, while lower endoscopy shows abnormalities in just 30% of cases (2).

Tissue Biopsy

The definitive diagnosis requires finding eosinophils in tissue samples from your digestive tract. These inflammatory cells are typically found in the mucosal or submucosal layers of the stomach or intestines.

Interestingly, while certain features like basal plasmacytosis and mucosal eosinophilia were thought to help distinguish between inflammatory bowel disease and other types of colitis, a recent systematic review found that these features don’t reliably differentiate between the conditions (6).

Tip
If you have unexplained gastrointestinal symptoms and elevated eosinophil counts in your blood, ask your doctor about the possibility of EGE. Even if endoscopy looks normal, tissue biopsies might still reveal the diagnosis.

Treatment Options

Treatment for EGE aims to reduce inflammation and control symptoms. Several approaches have shown promise in clinical studies.

Corticosteroids

Corticosteroids are often the first treatment choice. In the systematic review of EGE cases associated with autoimmune diseases, 95% of patients had favorable outcomes with corticosteroid treatment (2).

Newer Targeted Therapies

Recent research has explored new treatments that specifically target eosinophils:

Benralizumab: This medication targets the interleukin-5 receptor and helps deplete eosinophils. A phase 2 trial at Cincinnati Children’s Hospital Medical Center studied its effectiveness for eosinophilic gastritis, a related condition (7).

Treatment Trends

A systematic review of clinical trials found that treatment research for EGIDs is expanding. The review examined multiple therapeutic interventions and methods of administration being investigated (1).

Comparison with Eosinophilic Esophagitis

While EGE and eosinophilic esophagitis (EoE) are related conditions, they have important differences.

Location and Prevalence

EoE affects only the esophagus and is becoming more common. In Asia, the prevalence of EoE increased from 19.8 per 100,000 individuals in 2005-2009 to 73.0 per 100,000 individuals in 2015-2019 (8).

Unlike EoE which is primarily found in the esophagus, EGE can affect different parts of the digestive system. Among EGID cases associated with autoimmune diseases, eosinophilic gastritis and/or enteritis represented 95% of cases, while eosinophilic esophagitis is less common in this population (2).

Food Impaction Risk

Food getting stuck in the esophagus (food impaction) is a common complication of EoE but is less common with EGE. A meta-analysis found that among people who had food impaction and underwent biopsies, 54% were diagnosed with EoE (9).

Treatment Response

Treatment approaches for EoE have been extensively studied. A network meta-analysis comparing treatments for EoE found that topical steroids may be effective, though controversy remains about optimal treatment (10).

Fact
The incidence of eosinophilic esophagitis is much higher in children (12.3 cases per 1,000 patients) compared to adults (0.2 cases per 1,000 patients) in hospital-based studies (8).

Clinical Trial Considerations

Understanding clinical trials is important if you’re considering participating in research for EGE treatment.

Placebo Response Rates

Clinical trials for eosinophilic gastrointestinal diseases often show high placebo response rates. This means some people improve even when receiving inactive treatment. A meta-analysis examined placebo rates across different outcomes in EoE trials to help design better future studies (11).

Standardizing Treatment Outcomes

Researchers are working to standardize how treatment success is measured. A network meta-analysis comparing pharmacological interventions for EoE in adults and children examined histological outcomes to help determine the most effective treatments (12).

Living with Eosinophilic Gastroenteritis

Managing EGE often requires ongoing care and lifestyle adjustments.

Monitoring Your Condition

Regular follow-up with your healthcare provider is important. This may include:

  • Periodic blood tests to check eosinophil levels
  • Symptom tracking to assess treatment effectiveness
  • Repeat endoscopies to monitor tissue inflammation
  • Adjusting medications based on your response

Managing Related Conditions

Since EGE often occurs with other conditions, comprehensive care is important. If you have an autoimmune disease, managing both conditions together may improve outcomes. The research shows that in most cases where EGE occurs with autoimmune diseases, the autoimmune condition is diagnosed first (2).

Quality of Life Considerations

EGE can significantly impact your daily life. Working with a healthcare team that understands the condition can help you develop strategies to manage symptoms and maintain your quality of life.

Summary
Eosinophilic gastroenteritis is a rare but manageable condition. With proper diagnosis and treatment, most people experience significant improvement. If you have persistent digestive symptoms along with elevated eosinophil counts, discuss the possibility of EGE with your healthcare provider.

Future Research Directions

Research into eosinophilic gastrointestinal diseases continues to evolve, offering hope for better treatments.

Understanding Disease Mechanisms

Scientists are working to better understand why eosinophils accumulate in the digestive tract. The connection between EGIDs and conditions affecting the intestinal barrier, such as autism spectrum disorder, may provide new insights into disease mechanisms (4).

Developing New Treatments

Clinical trials are investigating various new approaches to treating EGIDs. The systematic review of treatment trends shows that research is expanding to include different therapeutic interventions and delivery methods (1).

Global Perspectives

As awareness of eosinophilic gastrointestinal diseases grows worldwide, more research is emerging from different regions. The increasing prevalence documented in Asia suggests these conditions may be more common than previously thought (8).

When to See a Doctor

Recognizing when to seek medical attention is crucial for getting proper diagnosis and treatment.

Warning Signs

You should see a healthcare provider if you experience:

  • Persistent abdominal pain that doesn’t improve
  • Unexplained weight loss
  • Chronic diarrhea or vomiting
  • Difficulty swallowing or food getting stuck
  • Blood in your stool

Getting the Right Diagnosis

Because EGE symptoms overlap with many other conditions, getting an accurate diagnosis is important. Don’t hesitate to ask for a referral to a gastroenterologist if your symptoms persist despite initial treatment.

Warning
If you experience severe abdominal pain, persistent vomiting, or signs of dehydration, seek immediate medical attention. These symptoms could indicate a serious complication requiring urgent care.

Is eosinophilic gastroenteritis the same as food allergies?

No, EGE is different from typical food allergies. While food allergies cause immediate reactions, EGE involves chronic inflammation in the digestive tract. Interestingly, most people with EGE don’t have a history of allergies, especially when EGE occurs with autoimmune diseases.

Can children get eosinophilic gastroenteritis?

Yes, children can develop EGE. In fact, eosinophilic gastrointestinal diseases may be more common in children than adults. If your child has persistent digestive symptoms, discussing the possibility of EGE with their pediatrician is important.

Will I need to take medication forever?

Treatment duration varies by individual. Some people may need long-term treatment to control symptoms, while others might be able to reduce or stop medication over time. Your healthcare provider will work with you to find the best long-term management plan.

Conclusion

Eosinophilic gastroenteritis is a complex condition that requires careful diagnosis and management. While it can significantly impact your quality of life, effective treatments are available. Most people with EGE respond well to treatment, with 95% showing favorable outcomes with appropriate therapy.

As research continues, our understanding of EGE and related conditions improves. New treatments are being developed, and clinical trials offer hope for even better options in the future. If you suspect you might have EGE, work with your healthcare provider to get an accurate diagnosis and develop a treatment plan that works for you.

Remember that EGE is manageable, and with the right care, you can control your symptoms and maintain a good quality of life. Stay informed about new developments, maintain regular follow-ups with your healthcare team, and don’t hesitate to seek support when you need it.

Was this article helpful?