Eosinophilic colitis (EC) is the buildup of white blood cells called eosinophils in the large intestine. EC can lead to inflammation, tissue damage, ulcers, and polyps.
There are 2 types of EC:
EC in infants will go away on its own with time. Adolescent EC may happen in periods without symptoms and periods when symptoms are severe.
It is not clear what causes EC. It is likely a blend of genetics and the environment.
Eosinophils are part of the immune system response to problems in the body. Part of their normal function is to release a chemical that causes inflammation. With EC, eosinophils build up and lead to regular irritation and damage to tissue in the large intestine over time. It is not clear what causes the buildup. It may be a response to an allergen.
EC is more common in males. Other factors that may increase your 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 medical history. A physical exam will be done. EC is hard to diagnose with simple tests. However, some tests may be able to rule out other diseases with similar symptoms.
Tests to rule other other conditions may include:
A biopsy is the only way to confirm EC. During a biopsy, tissue samples from a colonoscopy are examined under a microscope to confirm a diagnosis
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EC in infants will go away on its own. Removing cow’s milk and soy from the diet might manage symptoms until EC is gone.
For recurring EC, the goal of treatment is to manage inflammation and reduce 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:
Medications are used to manage EC and treat complications. These may include:
There are no current guidelines 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 June 15, 2017.
Eosinophilic colitis. EoE Resource website. Available at: http://www.eosinophilicesophagitisresource.org/eosinophilic-colitis. Accessed June 15, 2017.
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 2017 by EBSCO Medical Review BoardMichael Woods, MD, FAAP