Definition

Eosinophilic gastroenteritis (EGE) is the buildup of white blood cells called eosinophils. It causes inflammation in the stomach and lining of the intestines. This can lead to tissue damage, ulcers, and polyps. It can also make it difficult to absorb nutrients from food.

EGE may have time with symptoms and time with severe symptoms.

Causes

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 EGE, 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 EGE. It is likely a blend of gene defects and the environment. It may also be linked to an allergic reaction.

Risk Factors

Factors that may increase your child’s chances of EGE include:

Symptoms

Symptoms may include:

  • Severe belly pain
  • Bloating
  • A feeling of fullness after eating a small amount
  • Heartburn
  • Nausea
  • Vomiting
  • Diarrhea, with or without blood
  • Fatigue
  • Problems feeding in infants

Complications may include:

  • Malnutrition
  • Weight loss
  • Anemia or iron deficiency from blood loss

Diagnosis

You will be asked about your child’s symptoms and past health. A physical exam will be done. EGE is hard to diagnose with simple tests. Some tests may be able to rule out other conditions with similar symptoms.

Tests to rule out other conditions may include:

A biopsy is the only way to confirm EGE. A sample of the stomach or intestine will be removed. It will be sent to a lab to look for eosinophils. This will be done through a colonoscopy.

Upper GI Endoscopy
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Treatment

EGE cannot be cured. For some people, removing cow’s milk and soy from the diet might help. This is mainly true for infants.

For others, the goal of treatment is to manage inflammation. This will stop or slow damage to the tissue. If an underlying cause is identified, it will need to be treated.

Dietary Changes

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. Some complications include:

  • Some may have severe protein limits. Special liquid formulas may be needed to provide safer forms of protein. In some cases, a feeding tube may be used.
  • A nutrition plan may be needed to support growth. This may include vitamins and supplements.

Medicine

Medicines are used to manage EGE and treat complications. These may include:

  • Steroid pills—to reduce inflammation during flare ups
  • Medicine—to boost, change, or suppress the effects of the immune system
  • Medicine to reduce stomach acid

Medicine to manage allergies or asthma may also be needed.

Prevention

There are no current steps to prevent EGE because the cause is unknown.

RESOURCES:

American Partnership for Eosinophilic Disorders
http://apfed.org

Healthy Children—American Academy of Pediatrics
https://www.healthychildren.org

CANADIAN RESOURCES:

Canadian Association of Gastroenterology
https://www.cag-acg.org

Sick Kids—The Hospital for Sick Children
http://www.sickkids.ca

REFERENCES:

About eosinophilic gastroenteritis (EGE). The Southeast Eosinophilic Disease Center of Atlanta, Inc. website. Available at: https://www.seedcenteratl.org/about-eosinophilic-gastroenteritis-ege. Accessed January 11, 2018.

Eosinophilic gastroenteritis. American Partnership for Eosinophilic Disorders website. Available at: http://apfed.org/about-ead/egids/ege. Updated November 11, 2014. Accessed January 11, 2018.

Shih HM, Bair MJ, Chen HL, Lin IT. Eosinophilic Gastroenteritis : Brief Review. Acta Gastroenterol Belg. 2016 Apr-Jun;79(2):239-44.

Uppal V, Kreiger P, Kutsch E. Eosinophilic Gastroenteritis and Colitis: a Comprehensive Review. Clin Rev Allergy Immunol. 2016 Apr;50(2):175-88.

Last reviewed March 2018 by EBSCO Medical Review BoardMichael Woods, MD, FAAP  Last Updated: 1/8/2019