What is Eosinophilic Gastritis (EoG)?

Eosinophilic gastritis (EoG) is a rare disease of the stomach. In EoG, a type of white blood cell, called the eosinophil, gathers in large numbers in the stomach. Having too many eosinophils can cause injury and irritation to the stomach. EoG affects people of all ages. People with EoG often have other allergic conditions such as rhinitis (runny nose), asthma and / or eczema (skin rashes).

Eosinophilic Gastritis Causes

In many cases, it is not known what causes EoG. People with a personal or family history of allergic conditions may be at higher risk of having EoG.

Eosinophilic Gastritis Symptoms

• Vomiting
• Nausea (upset stomach)
• 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 red blood cell counts)
• Fatigue (tired feeling)

Eosinophilic Gastritis Diagnosis

Your child’s doctor may do some tests to find out if there are eosinophils in the stomach. These tests include an endoscopy. We also call this an upper scope. During this scope, your child is placed under anesthesia. The scope is done as an outpatient visit in same-day surgery. Your child’s doctor will put a small tube down the esophagus and into the stomach and part of the small intestine. The doctor will collect small tissue samples from each section of the upper gastrointestinal tract. These are called biopsies. A doctor will review the biopsies to see if there are eosinophils and what the tissue looks like.

It is normal for the stomach to have some eosinophils to protect against illness and parasites. There is not a defined number for how many eosinophils in the stomach are “too high”. Lack of defined guidelines can make it hard to diagnose.

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

• 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 stomach can occur in many conditions. EoG cannot be diagnosed on eosinophil levels alone.

Eosinophilic Gastritis Treatment

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

• Medicines that decrease inflammation (swelling)
• Medicines that decrease the immune system
• Changes in the diet
• Investigational Medicines — These medicines may help reduce the number of eosinophils in the stomach. Our hospital is doing research and clinical trials to study how these medicines can help children with EoG.

Medicine or diet changes may be prescribed to treat symptoms. Medicines may include those that reduce swelling and decrease the immune system, like steroids. Patients may also need help with 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 EoG symptoms but do not cure it. Medicines or diet changes will be needed for the child’s lifetime to keep EoG inactive and symptoms in check.

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