Eosinophilic gastroenteritis (EGE) is a rare digestive disease involving a type of white blood cell called ‘eosinophils’. In EGE, large numbers of eosinophils build up in the stomach and small intestine, causing inflammation and tissue damage.
People with EGE may experience various gastrointestinal symptoms, such as abdominal pain, nausea, vomiting, and fatigue. Several treatments are available to help relieve inflammation and manage symptoms.
This article explains EGE, including its symptoms and causes. We also outline the risk factors for EGE and provide information on diagnosis, treatment, and outlook.
Eosinophilic gastroenteritis (EGE) is a rare digestive disorder in which large numbers of white blood cells — eosinophils — accumulate in the stomach and small intestine, causing inflammation and tissue damage. This can result in the following symptoms:
The American Partnership of Eosinophilic Disorders (APFED) states that eosinophilic disorders can occur in many parts of the body, and their diagnoses depend on the location. While eosinophilic diseases are rare, eosinophilic gastrointestinal disorders (EGIDs) are the most common.
The APFED identifies four types of EGIDs, which affect different parts of the digestive tract. These are:
- eosinophilic colitis, affecting the large intestine
- eosinophilic esophagitis, affecting the esophagus
- eosinophilic gastritis, affecting the stomach
- eosinophilic gastroenteritis, affecting both the stomach and small intestine
Eosinophils are a type of white blood cell that plays an important role in the immune response. They help the body fight off infection, particularly parasitic infections.
Usually, eosinophils make up less than 5% of white blood cells in the bloodstream. A doctor may suspect a person has an EGID if there are increased numbers of eosinophils in their blood, tissues, or digestive system.
Symptoms of EGE can vary from person to person, depending on the extent of damage to the gastrointestinal wall.
According to the International Foundation for Gastrointestinal Disorders (IFFGD), EGE symptoms may include:
- abdominal pain that may feel dull or sharp
- difficulty eating
- weight loss
- poor growth, which is more common among infants and children
In some cases, eosinophils can infiltrate the layer of tissue beneath the outer lining of the stomach or small intestine. This can cause fluid buildup, which may result in abdominal pain and bloating.
According to the Canadian Society for Intestinal Research (CSIR), people with EGE may wait years for a correct diagnosis. This is because the symptoms of EGE are similar to those of other gastrointestinal diseases, including:
Experts do not know the exact cause of EG, though allergies likely play a role. The National Organization for Rare Diseases (NORD) states that food allergies and hypersensitivities are common among people with EGE.
People with a family history of one or more of the following conditions may also be at increased risk of developing EGE:
The CSIR states that people of all ages and ethnicities can develop EGE. However, the condition is more common among the following groups:
- Males: EGE is slightly more prevalent in males than females.
- Adults: EGE is more likely among adults aged between 20–50 years.
- People with allergies: Between 70–80% of people with EGE have preexisting allergies.
To diagnose a person with EGE, a doctor will first perform a medical examination and take their full medical history. If the doctor suspects EGE, they may order the following tests:
- Endoscopy: A procedure that involves inserting a tiny camera down the esophagus and into the stomach to check for ulcers or areas of irritation in the digestive tract. Doctors may also use this procedure to collect a tissue sample for biopsy.
- Surgical biopsy: This procedure obtains a full thickness sample for doctors to study in more detail. If a person has EGE, the samples may show areas of chronic inflammation.
- Allergy testing: This procedure helps test for food allergies. It may involve skin prick testing or an oral food challenge. In skin prick testing, an allergist applies small traces of suspected food allergens to the skin on a person’s forearm and waits for an allergic response. In an oral food challenge, the allergist has a person slowly eat increasing amounts of a suspected food allergen and waits for an allergic reaction.
There is currently no cure for EGE. However, treatments can help to manage the disease and alleviate symptoms.
The exact treatment approach depends on symptom type and severity. Possible treatment options include:
- Medications to control inflammation: A doctor may prescribe anti-inflammatory drugs or systemic steroids to reduce inflammation in the stomach and small intestine.
- Dietary changes: This includes identifying and eliminating any foods that trigger an allergic response.
- Nutritional support: People who experience malnourishment due to EGE may need iron supplements or other forms of nutritional support. Very occasionally, doctors may prescribe an elemental diet, in which all nutrition comes from a specially formulated drink. The drink is unpalatable, so most people require a feeding tube. As such, doctors do not recommend the treatment long term.
Eosinophilic gastroenteritis is a chronic condition, meaning that the symptoms may come and go.
According to the IFFGD, treatment for EGE is ongoing. The organization recommends a person receives support from a mixed healthcare team composed of the following medical professionals:
- a gastroenterologist who can help investigate, diagnose, and treat gastrointestinal issues
- an allergist who can help identify allergic triggers
- a dietitian who can help plan nourishing meals
Together, a team of medical professionals can help people with EGE manage their symptoms and achieve optimal overall health.
Anyone who experiences symptoms of EGE should make an appointment with their doctor, especially if they have a personal history or family history of allergies.
Symptoms of EGE may come and go, so it is important for people to inform a doctor about all previous and current symptoms.
EGE is a chronic digestive condition in which eosinophils accumulate in the stomach and small intestine, triggering inflammation and tissue damage in these areas. People with EGE may experience various gastrointestinal symptoms, such as abdominal pain, nausea, and vomiting. Those with malnourishment due to EGE may also experience fatigue.
Experts do not know the exact cause of EGE, but the condition appears more prevalent among people with preexisting allergies. Indeed, food allergy testing may help diagnose EGE. Other diagnostic tests include endoscopy and tissue biopsies.
Although there is no cure for EGE, treatments can help to manage inflammation and alleviate symptoms. Possible treatment options include anti-inflammatory medications, dietary changes, and nutritional support.