What is Eosinophilic Colitis?

Eosinophilic Colitis (EoC) is a rare disease of the colon, or large intestine. In EoC, a type of white blood cell, called the eosinophil, gathers in large numbers in the colon. Too many eosinophils can cause injury and irritation to the colon. EoC affects people of all ages. EoC often presents in the first six months of life, but it can be seen at any age.

Causes of Eosinophilic Colitis

The cause of EoC is not known in most cases. People with a personal or family history of allergic conditions may be at higher risk of having EoC.

Eosinophilic Colitis Symptoms

• Diarrhea, sometimes with blood
• Trouble eating (such as: loss of appetite, problems swallowing, refusal to eat, eating slowly, not eating enough)
• Hard to gain weight
• Poor growth and weight loss
• Stomach pain
• Anemia (low numbers of red blood cells)
• Fatigue (feeling tired)

Eosinophilic Colitis Diagnosis

Your child’s doctor may do some tests to find out how many eosinophils are in the colon. These tests include an endoscopy or colonoscopy. We also call these tests upper and lower scopes.

During an upper scope, your child’s doctor will put a small tube down the esophagus and into the stomach. During a lower scope, a lighted tube is put into the anus, rectum and large intestine. The patient is under anesthesia for the scopes. The scope is done as an outpatient visit in same-day surgery. During the scopes, small samples of tissue are taken from the gastrointestinal tract. These are called biopsies.

A doctor reviews the biopsies to see how many eosinophils there are and what the tissue looks like. It is normal for the large intestine to have some eosinophils to protect against infections and parasites. There is not a defined number for how many eosinophils in the colon are “too high”. Lack of these defined guidelines can make it hard to diagnose.

A doctor will look at these in order to diagnose EoC:

• Symptoms
• Medical history
• What the doctor saw during the scope
• Pathology report (eosinophil levels, what the tissue samples look like)

High eosinophil levels in the colon can occur in many conditions. EoC cannot be diagnosed on eosinophil levels alone.

Eosinophilic Colitis Treatment

There are no defined guidelines for the treatment of EoC. For infants, changing formulas may help. In older people, the EoC has likely been there for a long time. EoC may respond to:

• Medicines that decrease inflammation (swelling)
• Medicine that decreases the immune system
• Changes in the diet Medicine may be prescribed to treat symptoms.

Medicine may include those that reduce swelling and decrease the immune system, like steroids. Patients may also need help meeting their nutrition needs and goals. This will depend on how severe the disease is and on the results of the bloodwork. Medicines help to lessen the activity of EoC but do not cure it. Medicines or diet changes will be needed for the child’s lifetime to keep EoC inactive and symptoms in check.

Having routine scopes with tissue samples is needed to check EoC and to see if the treatment is working.