What is Eosinophilic Enteritis?

Eosinophilic enteritis, formerly known as eosinophilic gastroenteritis (EGE), is a rare disease in which a type of white blood cell, the eosinophil, gathers in the small bowel, a part of the gastrointestinal (GI) tract. This causes injury and inflammation in that area. Eosinophilic enteritis can affect both adults and children. People with eosinophilic enteritis often have other gastrointestinal problems. There may be a genetic cause to eosinophilic enteritis.

Eosinophilic Enteritis Causes

In many cases, it is not known what causes eosinophilic enteritis. Food and / or environmental allergies may lead to development of this disease.

Eosinophilic Enteritis Symptoms

• Vomiting
• Nausea
• Difficulty feeding
• Difficulty gaining weight, weight loss
• Poor growth
• Abdominal pain
• Low red blood cell counts (anemia) - may cause a fast heart beat, paleness, being tired
• Diarrhea
• Constipation
• Fatigue
• Digestive system cannot properly absorb nutrients from the food you eat (malabsorption and protein-losing enteropathy)

Eosinophilic Enteritis Diagnosis

An endoscopy with tissue biopsies is the only way to diagnose eosinophilic enteritis. Depending on your child’s symptoms, a doctor will perform an upper endoscopy and / or a lower endoscopy. A lower endoscopy may also be called a colonoscopy. An upper endoscopy involves a small tube going through the mouth to the esophagus, stomach and part of the small intestine. For a lower endoscopy, the doctor places a tube into the anus, rectum and large intestine. For both types of endoscopies, your child is under anesthesia. These procedures usually take 30 to 60 minutes.

Small tissue samples will be taken. These samples are called biopsies. A doctor who specializes in studying lab specimens (called a pathologist) will look at these biopsies to see if there are more eosinophils than normal. There is not a set number of eosinophils that lead to a diagnosis. That is why a diagnosis can be difficult.

A doctor will use symptoms, what they see during the endoscopies, and the pathology report to diagnose your child.

Eosinophilic Enteritis Treatment

Eosinophilic enteritis is treated by diet changes or medications. Diet changes may include elimination diets. This is when certain foods or common food allergens are removed from your child’s diet. Elemental diets, —when all food is removed and nutrition is given by a specialized formula —are another option for some children with severe disease. You, along with your child’s doctor and dietitian will determine what foods to eliminate and when and how to add food back into their diet. Medications may be prescribed.

Your child may need nutritional supplements. Medication and nutritional supplement needs vary for each child. Other therapies are still being researched.

Treatment helps the symptoms of eosinophilic enteritis but does not cure it. Eosinophilic enteritis is a life-long condition. Having endoscopies with tissue biopsies regularly is needed to check for disease activity in children with eosinophilic enteritis.

Every time your child has an endoscopy, biopsies will be looked at by pathology. This helps to see if treatment is working and if changes should be made to your child’s treatment plan. Your child will regularly see their doctor in the office to talk about how they are feeling and make treatment plan decisions.