Definition
Eosinophilic gastroenteritis (EGE) is the buildup of white blood cells called eosinophils. It causes inflammation in the stomach and lining of the intestines. This can lead to tissue damage, ulcers, and polyps. It can also make it difficult to absorb nutrients from food.
Causes
Eosinophils are part of the immune system. They should only respond to an infection or injury. These cells release a chemical that causes inflammation. With EGE, the inflammation starts or continues even though it is not needed. Over time this can lead to tissue damage, ulcers, and polyps in the colon.
It is not clear what causes EGE. It is likely a blend of gene defects and the environment. It may also be linked to an allergic reaction.
Risk Factors
Factors that may increase your child’s chances of EGE include:
- Certain genetic problems
- Family members with EGE or allergies
- Food allergies
- Seasonal allergies
- Atopic dermatitis
- Having other conditions, such as other eosinophilic gastrointestinal diseases
Symptoms
Symptoms can vary from mild to severe. They may include:
- Severe belly pain
- Bloating
- 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
- Weight loss
- Anemia or iron deficiency from blood loss
Diagnosis
You will be asked about your child’s symptoms and past health. A physical exam will be done. EGE is hard to diagnose with simple tests. Some tests may be able to rule out other conditions with similar symptoms.
Tests to rule out other conditions may include:
- Blood tests
- Allergy tests
- Endoscopy—a lighted tube is used to view the stomach and small intestine
A biopsy is the only way to confirm EGE. A sample of the stomach or intestine will be removed. It will be sent to a lab to look for eosinophils. This will be done through a colonoscopy.
Upper GI Endoscopy |
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Treatment
EGE cannot be cured. For some people, removing cow’s milk and soy from the diet might help. This is mainly true for infants.
For others, the goal of treatment is to manage inflammation. This will stop or slow damage to the tissue. If an underlying cause is identified, it will need to be treated.
Dietary Changes
Foods that cause symptoms will need to be avoided. Proteins, such as soy, nuts, eggs, or milk are common allergens. A dietitian can help to guide dietary needs. Some complications 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
Medicines are used to manage EGE and treat complications. These may include:
- Steroid pills—to reduce inflammation during flare ups
- Medicine—to boost, change, or suppress the effects of the immune system
- Medicine to reduce stomach acid
Medicine to manage allergies or asthma may also be needed.
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
About eosinophilic gastroenteritis (EGE). The Southeast Eosinophilic Disease Center of Atlanta, Inc. website. Available at: https://www.seedcenteratl.org/about-eosinophilic-gastroenteritis-ege. Accessed January 28, 2021.
Eosinophilic gastroenteritis. American Partnership for Eosinophilic Disorders website. Available at: http://apfed.org/about-ead/egids/ege. Accessed January 28, 2021.
Shih HM, Bair MJ, Chen HL, Lin IT. Eosinophilic Gastroenteritis : Brief Review. Acta Gastroenterol Belg. 2016 Apr-Jun;79(2):239-44.
Uppal V, Kreiger P, Kutsch E. Eosinophilic Gastroenteritis and Colitis: a Comprehensive Review. Clin Rev Allergy Immunol. 2016 Apr;50(2):175-88.
Revision Information
- Reviewer: EBSCO Medical Review Board Chelsea Skucek, MSN, BS, RNC-NIC
- Review Date: 03/2020
- Update Date: 01/28/2021