Eosinophilic colitis (EC) is the buildup of white blood cells called eosinophils. They gather in the lining of the colon. EC causes long term inflammation.
There are two types of EC:
EC in infants will go away on its own with time. Adolescent EC may cycle between symptom free and severe symptoms.
Eosinophils are part of the immune system. They should only respond to an infection or injury. These cells release a chemical that causes inflammation. With EC, the inflammation starts or continues even though it is not needed. Over time this can lead to tissue damage, ulcers, and polyps in the colon.
It is not clear what causes EC. It is likely a blend of gene defects and the environment. It may also be linked to an allergic reaction.
EC is more common in males. Other factors that may increase a child’s chances of EC include:
Symptoms vary and may be more severe in some people.
Common symptoms include:
Complications may include:
You will be asked about your child’s symptoms and past health. A physical exam will be done. EC is hard to diagnose with simple tests. Some tests may be able to rule out other conditions with similar symptoms.
Tests to rule other other conditions may include:
A biopsy is the only way to confirm EC. A sample of the colon will be removed. It will be sent to a lab to look for eosinophils. This will be done through a colonoscopy.
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EC in infants will go away on its own. Removing cow’s milk and soy from the diet may help until EC is gone.
For others, the goal of treatment is to manage inflammation. This will stop or slow damage to the lining of the colon. If an underlying cause is identified, it will need to be treated.
Treatment options may include:
Foods that cause symptoms will need to be avoided. Proteins, such as soy, nuts, eggs, or milk are common allergens. A dietitian can help to guide dietary needs.
Other changes may include:
Medicines are used to manage EC and treat complications. These may include:
There are no steps to prevent EC because the cause is unknown.
American Partnership for Eosinophilic Disorders
Healthy Children—American Academy of Pediatrics
Canadian Association of Gastroenterology
Sick Kids—The Hospital for Sick Children
Alfadda AA, Storr MA, Shaffer EA. Eosinophilic colitis: epidemiology, clinical features, and current management. Therap Adv Gastroenterol. 2011;4(5):301-309.
Eosinophilic colitis. American Partnership for Eosinophilic Disorders website. Available at: http://apfed.org/about-ead/egids/ec. Updated November 11, 2014. Accessed January 11, 2019.
Lozinsky AC, Morais MB. Eosinophilic colitis in infants. J Pediatr (Rio J). 2014;90(1):16-21.
Uppal V, Kreiger P, Kutsch E. Eosinophilic gastroenteritis and colitis: a comprehensive review. Clin Rev Allergy Immunol. 2016;50(2):175-188.
Last reviewed March 2018 by EBSCO Medical Review BoardMichael Woods, MD, FAAP Last Updated: 1/8/2019