Eosinophilic gastroenteritis

Last revised by Dr Yahya Baba on 11 Aug 2021

Eosinophilic gastroenteritis (EG) is an uncommon disease characterized by diffuse infiltration of any or all layers of gut wall by eosinophils. 

Eosinophilic gastroenteritis is an uncommon but not rare disease with slight male predominance. It can affect any age group but usually patients present in their 3rd to 5th decades of life. 

  • self-limiting disorder in the majority of cases
  • patients may present with dysphagia, food impaction, abdominal pain, nausea, vomiting, or diarrhea depending on the site of involvement
  • in severely affected children it may result in growth retardation
  • ascites and pleural effusions may be present 
  • chronic inflammatory disorder of GI wall of undetermined pathophysiology, although atopy-related genes, inflammatory cells, and mediators play a role in the pathogenesis of eosinophilic gastroenteritis
  • history of allergy, in particular food allergy, is present in approximately 50% of cases
  • more than 60% of cases show peripheral eosinophilia 
  • on biopsy, there is evidence of mucosal edema and infiltration of the eosinophils, polymorphonuclear leukocytes (PMNs), and lymphocytes in different layers of the gut wall

It can affect various segments of the bowel which include

  • eosinophilic esophagitis may show a "ringed esophagus" (series of ring-like strictures), and/or smooth long segment narrowing of the esophagus 
  • gastrointestinal involvement is more common
    • virtually always involves gastric antrum and proximal small intestine
    • non-specific mucosal fold thickening and nodularity particularly in the gastric antrum, without submucosal edema
    • when chronic, the antrum is narrowed with a nodular "cobblestone" mucosal appearance
  • CT features are non-specific and may show GI wall thickening and submucosal edema
  • responds well to oral corticosteroids and dietary exclusion 

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  • Case 1
    Drag here to reorder.
  • Case 2
    Drag here to reorder.
  • Case 3
    Drag here to reorder.
  • Case 4
    Drag here to reorder.
  • Case 5
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.