Eosinophilic gastritis (EG) is a disease of the immune system that affects the gastrointestinal (GI) system. Gastritis refers to inflammation of the lining of the stomach and intestinal tract. The “eosinophilic” description of this disease refers to the fact that the inflammation is related to an abundance of a type of white blood cells called eosinophils in the walls of the stomach and intestinal tract. This special type of white blood cell is involved in the body’s response to parasites and in allergies.  EG affects people of all ages though is more common in children and young adults.

SYMPTOMS

• Nausea after eating

• Abdominal pain

• Vomiting

• Diarrhea Bowel obstruction (intestines are blocked by an extremely thickened wall

• Weight loss

• Ascites (an accumulation of fluid in the abdominal cavity similar to bloating)

• Food allergies or food intolerances

WHAT CAUSES EOSINOPHILIC GASTRITIS?

The cause for the signs and symptoms is related to the infiltration of the eosinophils within the GI wall. The infiltration leads to a thickening of the intestinal wall which contributes to any or all of the signs and symptoms listed above. Exactly which symptoms the child has depends on what layer of the intestine is infiltrated and the extent and severity of the infiltration. How and why the infiltration of eosinophils into the GI tract happens is not yet known. It has been thought that some precipitating stimuli to the GI system might cause an immune response. This immune system response then becomes hypersensitisized due to unknown mechanisms. There are two groups of patients, one in whom it is possible to identify particular foods that provoke the syndrome, and a second group in which foods do not appear to make any difference. This is important in treating the disease.

HOW IS EOSINOPHILIC GASTRITIS DIAGNOSED?

is confirmed by a scope (upper endoscopy).  A scope is used as it gives the gastroenterologist the ability to see the esophagus, stomach and duodenum (first part of the small bowel) as well as tissue samples for review under a microscope.  If EE is not visible during the exam, they will be found under a microscope.  Sometimes a blood sample will show higher than normal levels of eosinophils in the blood as well.

TREATMENTS FOR EOSINOPHILIC GASTRITIS

The treatment for eosinophilic gastroenteritis depends to some degrees on which of the 3 layers of the wall of the GI tract are affected. Children who are in the food triggered group may find some relief in adhering to a food elimination diet. A food elimination diet requires that a detailed diary is written of all foods the child eats and any correlating symptoms the child has. The goal is to discover those foods that most often trigger symptoms and if eliminating them relieves these symptoms. Food elimination diets should be done under a doctor’s care to ensure that appropriate conclusions are drawn from the diaries and that an adequate diet is maintained for growth and nutrition. In the group that does not have food-triggered symptoms, steroids are often used to reduce the inflammation. Recently, a new steroid (budesonide) that is not absorbed has been used to treat this disorder, and has shown promise in reducing symptoms without causing the side effects steroids usually have.