Eosinophilic Gastrointestinal Disorders

Clin Rev Allergy Immunol. 2019 Oct;57(2):272-285. doi: 10.1007/s12016-019-08732-1.

Abstract

Eosinophilic gastrointestinal disorders (EGID) are a group of disorders characterized by pathologic eosinophilic infiltration of the esophagus, stomach, small intestine, or colon leading to organ dysfunction and clinical symptoms (J Pediatr Gastroenterol Nutr; Spergel et al., 52: 300-306, 2011). These disorders include eosinophilic esophagitis (EoE), eosinophilic gastritis (EG), eosinophilic gastroenteritis (EGE), eosinophilic enteritis (EE), and eosinophilic colitis (EC). Symptoms are dependent not only on the location (organ) as well as extent (layer invasion of the bowel wall). Common symptoms of EoE include dysphagia and food impaction in adults and heartburn, abdominal pain, and vomiting in children. Common symptoms of the other EGIDs include abdominal pain, nausea, vomiting, early satiety, diarrhea, and weight loss. These disorders are considered immune-mediated chronic inflammatory disorders with strong links to food allergen triggers. Treatment strategies focus on either medical or dietary therapy. These options include not only controlling symptoms and bowel inflammation but also on identifying potential food triggers. This chapter will focus on the clinical presentation, pathophysiology, and treatment of these increasingly recognized disorders.

Keywords: Dysphagia; Eosinophilic esophagitis; Eosinophilic gastritis; Eosinophilic gastroenteritis; Food allergy; Food impaction.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Aged, 80 and over
  • Biological Therapy
  • Child
  • Child, Preschool
  • Diet Therapy
  • Enteritis / diagnosis
  • Enteritis / epidemiology*
  • Enteritis / physiopathology
  • Enteritis / therapy*
  • Eosinophilia / diagnosis
  • Eosinophilia / epidemiology*
  • Eosinophilia / physiopathology
  • Eosinophilia / therapy*
  • Eosinophilic Esophagitis / diagnosis
  • Eosinophilic Esophagitis / epidemiology*
  • Eosinophilic Esophagitis / physiopathology
  • Eosinophilic Esophagitis / therapy*
  • Female
  • Gastritis / diagnosis
  • Gastritis / epidemiology*
  • Gastritis / physiopathology
  • Gastritis / therapy*
  • Genetic Predisposition to Disease
  • Humans
  • Immunologic Factors / therapeutic use
  • Infant
  • Male
  • Middle Aged
  • Proton Pump Inhibitors / therapeutic use
  • Sex Factors
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Immunologic Factors
  • Proton Pump Inhibitors

Supplementary concepts

  • Eosinophilic enteropathy