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Definition

Eosinophilic gastritis (EG) is a condition that causes inflammation of the stomach. EG can make it hard for the body to get enough nutrients from food.

EG may occur in cycles. Symptom may fade or stop for a time, then may flare up again.

Cause

EG is caused by a build up of a white blood cells called eosinophils. These cells are part of the immune system. They cause inflammation if there is an infection or injury until the area heals. With EG, the eosinophils collect in tissue when they are not needed. This leads to long term inflammation. Over time damages tissue, and causes ulcers and polyps in the colon.

It is not clear what causes EG. It is likely due to a blend of gene defects and the environment. It may also be linked to an allergic reaction.

Risk Factors

Things that may increase a child’s chances of EG include:

  • Genetic health issues
  • Family members with allergies or asthma
  • Food allergies
  • Seasonal allergies
  • Atopic dermatitis—eczema
  • Other eosinophilic gastrointestinal diseases

Symptoms

EG may cause:

  • Severe belly pain
  • Swelling of the belly
  • A feeling of fullness after eating a small amount
  • Heartburn
  • Nausea
  • Vomiting
  • Diarrhea, with or without blood
  • Fatigue
  • Problems feeding in infants

Complications may include:

  • Malnutrition—physical problems due to not getting enough nutrients into your body
  • Weight loss
  • Anemia or iron deficiency from blood loss

Diagnosis

The doctor will ask about your child’s symptoms and past health. A physical exam will be done. EG can be hard to diagnose with simple tests. Other issues of the stomach or intestines can cause similar problems. Tests to rule out other conditions include:

  • Blood tests
  • Allergy tests
  • Endoscopy—a scope is passed through the mouth to the stomach; a sample of tissue will be removed

A biopsy is the only way to confirm EG. A sample of the stomach will be removed. It will be sent to a lab to look for eosinophils.

Upper GI Endoscopy
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Treatment

EG cannot be cured. Treatment will focus on slowing or stopping inflammation and tissue damage. Treatment options may include:

Dietary Changes

Certain foods may cause symptoms. They will need to be avoided. Milk and soy are often problems for infants.

Proteins, such as soy, nuts, eggs, or milk are also common allergens. A dietitian can help with meal planning.

Other diet changes may include:

  • Some may have severe protein limits. Special liquid formulas may be needed to provide safer forms of protein. In some cases, a feeding tube may be used.
  • A nutrition plan may be needed to support growth. This may include vitamins and supplements.

Medicine

Medicine may help to manage EG. These may include:

  • Steroids—to reduce inflammation during symptom flare ups. May be given as pills or passed into the colon.
  • Medicine to boost, change, or suppress the immune system.

Medicine may also be needed to treat related issues like heartburn or allergies.

Prevention

There are no steps to prevent EG because the cause is not clear.

RESOURCES

American Partnership for Eosinophilic Disorders  http://apfed.org 

Healthy Children—American Academy of Pediatrics  https://www.healthychildren.org 

CANADIAN RESOURCES

Canadian Association of Gastroenterology  https://www.cag-acg.org 

Sick Kids—The Hospital for Sick Children  http://www.sickkids.ca 

References

Eosinophilic gastritis. National Organization for Rare Disorders (NORD) website. Available at: https://rarediseases.org/rare-diseases/eosinophilic-gastroenteritis/. Updated: 2018. Accessed January 11, 2019.

Eosinophilic gastritis. American Partnership for Eosinophilic Disorders website. Available at: http://apfed.org/about-ead/egids/eg. Accessed January 11, 2019.

Fahey LM, Liacouras CA. Eosinophilic Gastrointestinal Disorders. Pediatr Clin North Am. 2017 Jun;64(3):475-485.

Zhang M, Li Y. Eosinophilic gastroenteritis: A state-of-the-art review. J Gastroenterol Hepatol. 2017 Jan;32(1):64-72.

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