Eosinophilic gastroenteritis: pathophysiology, symptoms, diagnostics, treatment

Petrauskaite Ieva 1, Proseviciute Ruta 1, Dijokaite Greta 1

1Lithuanian University of Health Sciences, Faculty of Medicine, Kaunas, Lithuania



Eosinophilic gastroenteritis is a rare, but an important disorder of the digestive tract. Its main pathogenetic mechanism is eosinophilic infiltration in the intestinal wall, occurring due to the activation of various inflammatory factors. The infiltrates can localise in many different spots – the disease may affect any part of the digestive tract from esophagus to rectum, although the most common places involved are a stomach and small intestine. Eosinophils can be detected in different depths of the intestinal wall – mucosa, muscular layer, serosa. Approximately half of the patients experience abdominal pain, vomiting, diarrhea or a combination of these symptoms. About two thirds of the patients also have elevated levels of eosinophils in peripheral blood samples. It is also observed that eosinophilic gastroenteritis is strongly related to allergic reactions to food. Moreover, about 70% of the people with eosinophilic gastroenteritis have other atopic diseases or family history of allergies. It is very important to differentiate this disease from other conditions that could cause the same symptoms or elevated levels of eosinophils. There is no golden standard for the diagnosis of eosinophilic gastroenteritis. In order to detect the disease, doctors perform various tests and observe clinical manifestations. One of the most important tests is the detection of eosinophilic infiltration in the tissue of the digestive tract, usually via endoscopic biopsy. One more thing that makes the diagnosis of the disease hard is that eosinophils can be localised only in the muscular layer or serosa, but not present in the mucosa. There are many treatment methods of eosinophilic gastroenteritis. Those include an elimination diet, corticosteroids, proton pump inhibitors and eradication of H. pylori, leukotriene receptor antagonists, mast-cell stabilisers, antihistaminic agents, biological therapy, fecal transplantation, surgery. Nowadays scientists find more and more methods of treatment that might be effective in modulating this disease, therefore it is very important to get a deeper understanding of etiology, pathophysiology and management of eosinophilic gastroenteritis.


Keywords:  Eosinophilic gastroenteritis, eosinophilic infiltration, eosinophils, abdominal pain.