Eosinophilic Gut Disease

Eosinophilic Gut Disease

The eosinophilic gut disease is an uncommon condition affecting the stomach, characterized by an accumulation of eosinophils, a type of white blood cell. This buildup causes inflammation and damage to the stomach lining.

This condition can affect individuals of any age and is considered a chronic or long-term problem. However, your doctor can guide you in managing symptoms through regular testing and dietary adjustments.

What Are Eosinophils?

Eosinophils are a type of white blood cell that plays a crucial role in supporting the immune system. Produced by the bone marrow (the soft tissue in the bones), eosinophils normally make up about 1% to 5% of the white blood cells in a healthy person.

Eosinophils can increase (a condition known as eosinophilia) in response to allergens, medications, infections, or cancer. When activated, they release enzymes and proteins to help eliminate harmful cells.

Excessive production of eosinophils can lead to inflammation in the stomach tissues (gastritis) or other body organs.

Types of Eosinophilic Gut Disease

Eosinophilic gastritis is a type of eosinophilic gut disease, a group of conditions that can impact various parts of the digestive system. It is possible to have multiple disorders simultaneously, especially when there is an elevated number of eosinophils.

The primary forms of eosinophilic gut disease are:

  • Eosinophilic colitis (EC): Affects the large intestine (colon).
  • Eosinophilic duodenitis: Impacts the first part of the small intestine.
  • Eosinophilic enteritis (EoN): Involves the small bowel.
  • Eosinophilic esophagitis (EoE): The most common type that affects the esophagus.
  • Eosinophilic gastritis (EG): Includes the stomach.
  • Eosinophilic gastroenteritis (EGE): Mainly affects both the stomach and small intestine.

Additional types of eosinophilic diseases likely to affect your gastrointestinal (GI) system include:

  • Hypereosinophilic syndrome: Linked to blood and any organ in the body.
  • Eosinophilic granulomatosis with polyangiitis (EGPA): A condition that can affect multiple organs, including the heart.

Symptoms

The location and degree of eosinophilic infiltration in the gastrointestinal tract determine the symptoms of eosinophilic gut disease. However, the following are some typical signs associated with this condition:

  • Abdominal pain
  • Anemia
  • Bloating
  • Chest pain
  • Diarrhea
  • Heartburn
  • Indigestion
  • Malnutrition
  • Nausea
  • Trouble swallowing
  • Vomiting
  • Weight loss

Due to malnutrition, children with eosinophilic gut disease may also display the following symptoms:

  • Delayed growth
  • Failure to thrive
  • Delayed puberty
  • Delayed or absent periods

Causes

Clinicians are uncertain of what causes eosinophilic gut disease. However, in many cases,  eosinophilic gut disease develops due to an abnormal immune system reaction to some foods.

Diagnosis

Diagnosing eosinophilic gut disease can be challenging because of its common symptoms. The diagnosis is typically determined by blood work (showing a high eosinophil count), changes observed in the stomach during an endoscopy, and examination of small tissue samples from the stomach under a microscope. If the eosinophils are found in the deeper stomach wall layers instead of the superficial lining, they may be difficult to detect with standard biopsies, which can delay diagnosis.

During diagnosis, your healthcare provider will:

  • Conduct a physical exam.
  • Inquire about your medical history.
  • Recommend blood tests like a complete blood count (CBC), to look for abnormalities and rule out other potential conditions.

Diagnostic Tests:

Your doctor may also order additional tests, including:

  • Upper endoscopy: This procedure is done using a tiny tube attached to a small camera to assess areas of the stomach, small intestines, and esophagus. Also, the provider checks for signs of irritation, swelling, or injury to the stomach.
  • Biopsy: During the endoscopy, a small tissue sample may be taken for examination. A pathologist examines the tissue in a laboratory. If the eosinophil count in the sample is higher than the standard range, it suggests eosinophilic gut disease.
  • Allergy testing: This can help identify food allergens that may contribute to an increase in eosinophils in your stomach. Being aware of the allergens involved can guide both diagnosis and treatment.

Treatment

Treatment options include:

  • Dietary therapy: This is the initial course of treatment and has the potential to significantly reduce eosinophilic gut disease symptoms. For food allergies, it’s essential to avoid trigger foods since they can exacerbate inflammation. The most effective way to administer dietary treatment is under a dietitian or nutritionist’s supervision.
  • Corticosteroids: These are the best class of medications for this illness because they reduce inflammation in the digestive tract and limit immune system activity. Up to 90% of patients with eosinophilic gut disease find them to be beneficial. Prednisone is the recommended course of treatment; however, prednisolone, fluticasone, and budesonide are frequently administered corticosteroids.
  • Antihistamines and mast cell stabilizers. The medications have also been suggested as treatment options for eosinophilic gut disease. Mast cell stabilizers function by reducing the actions of specific immune system cells, whereas antihistamines block the inflammatory effects of histamine.
  • Surgery: This is rarely recommended to address eosinophilic gut disease because the majority of other treatments, like medication and dietary therapy, are sufficient.

Prevention

Depending on the root cause of the condition, there are many ways to lower your chance of getting eosinophilic gut disease. High eosinophil levels are most frequently caused by allergies.

Medication and dietary modifications can help avoid or manage allergic reactions caused by your immune system. Your general risk of disease can be lowered with a healthy diet and way of living. If you have a family history of eosinophilic gut disease or allergies, consider consulting your doctor.

Living With

The impact of eosinophilic gut disease on your quality of life is based on the symptoms’ severity, any underlying disorders, and the success of your treatment. In many cases, managing the condition involves modifying your diet to avoid specific food allergens and perhaps taking drugs.

Dietary changes can be both physically and emotionally challenging. It may be difficult to plan meals or attend social events, and you may have to give up some of your favorite foods. However, by following your treatment plan and seeking assistance when necessary, you can manage the condition, feel better, and maintain an active lifestyle.

Conclusion

The eosinophilic gut disease is a rare, chronic condition of the stomach. Due to its symptoms closely resembling those of other common diseases, it can take time to reach a diagnosis. Although there is no cure, medicines, and dietary changes can help alleviate symptoms. Your provider will collaborate with you to develop an effective treatment plan aimed at improving both your symptoms and overall quality of life.

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