Eosinophilic gastroenteritis

Eosinophilic gastroenteritis (EGE), also known as eosinophilic gastroenteropathy, is a rare inflammatory disorder characterized by abnormal accumulation of eosinophils (a type of white blood cell) in the walls of the gastrointestinal tract, in the absence of other known causes of eosinophilia such as parasitic infections or drug reactions. The disease can affect any part of the gastrointestinal tract, from the esophagus to the colon, but most commonly involves the stomach and small intestine. It is classified into three subtypes based on the layer of the bowel wall predominantly affected: mucosal (most common), muscular, and serosal. The mucosal form typically presents with abdominal pain, nausea, vomiting, diarrhea, and malabsorption, while the muscular form may cause bowel obstruction, and the serosal form can lead to eosinophilic ascites (fluid accumulation in the abdomen). Eosinophilic gastroenteritis affects both children and adults, with a slight male predominance. Many patients have a personal or family history of allergic conditions such as asthma, eczema, or food allergies, suggesting an atopic or immune-mediated component to the disease. Peripheral blood eosinophilia is present in the majority of cases but is not universal. Diagnosis is established through endoscopic biopsies demonstrating dense eosinophilic infiltration of the gastrointestinal tissue, after exclusion of other causes. Treatment typically involves dietary modification, including elimination diets targeting suspected food allergens, and pharmacological therapy. Corticosteroids (such as prednisone or budesonide) are the mainstay of treatment and are effective in most patients, though relapses are common upon tapering or discontinuation. Mast cell stabilizers, leukotriene receptor antagonists, and immunomodulatory agents have been used as steroid-sparing therapies with variable success. Biologic therapies targeting interleukin pathways are under investigation. The disease tends to follow a chronic relapsing course, but life-threatening complications are rare.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

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