Eosinophilic gastritis and/or eosinophilic duodenitis (EG/EoD) is a condition that causes inflammation throughout the digestive system.
The symptoms associated with EG/EoD will vary from person to person, but can include:
It’s not known why some people develop EG/EoD, but many people with the condition also have a history of allergies. It may take time for EG/EoD to be diagnosed, which can be frustrating and difficult for patients. However, awareness among the physician community is increasing, and diagnoses are becoming more common through the use of an endoscopy where biopsies are taken. The biopsies are tested for the presence of a type of white blood cell called eosinophils, which could lead to a timely diagnosis of EG/EoD.
EG/EoD is a condition that affects the lining of the digestive tract (the mucosa). In this disease, there is an increase of a type of white blood cell called eosinophils in the mucosa. These cells are normally present in the colon, but their presence in the deeper layers of the lining is abnormal.
EG/EoD may affect the esophagus, stomach, and/or small and large intestines. Some common symptoms include abdominal pain, bloating, diarrhea, fatigue, nausea, and vomiting.
It’s not known what causes the development of EG/EoD. The condition is not well understood. Treatments are often used to manage symptoms, rather than treat the cause of the disease. However, medication that may treat the condition is being studied.
Patients will want to keep up on the latest news and research about EG/EoD. It’s also helpful to speak to physicians about how to stay informed about new developments in diagnosis and treatment of EG/EoD.
The symptoms of EG/EoD are not specific. Which is to say, they can be similar to those of several other diseases and conditions. This is one of the reasons why EG/EoD may not be diagnosed easily or timely, and why some patients are first misdiagnosed.
The gold standard for diagnosing EG/EoD is an endoscopy with biopsies. Along with the symptoms and a history of other conditions a patient has, a diagnosis of EG/EoD may be made. Patients may find that it is helpful to advocate for themselves and to ask for the right tests in order to make the diagnosis.
The lack of understanding about the causes behind the development of EG/EoD makes treatment difficult. At this time, treatments can include changes to diet and medications such as corticosteroids, mast cell stabilizers, and leukotriene receptor antagonists. Which therapies or combination of treatments might work best to control symptoms may include some trial and error.
New medications for EG/EoD, however, are under investigation. The continued increased awareness of the condition and the clinical trials on new medications will be important to developing improved treatment plans.
An elimination diet might be used as a treatment for the symptoms of EG/EoD. Undertaking a new diet plan should be done with the help of a registered dietitian, in order to give the best chance of success.
Removing a number o foods from the diet may be recommended. After a period of time, foods are re-introduced back into the diet gradually, one at a time. This usually includes two or more of mostly commonly allergenic foods:
Other diets may also be tried, including an elemental diet. An elemental diet involves substituting a special formula of liquid nutrition for meals. This diet is usually followed for a short period of time and under the close supervision of healthcare professionals.
The duodenum is the first part of the small intestine, located just after the stomach. Duodenitis is when that part of the small intestine is swollen, irritated, or inflamed. There can also be ulcers (holes) in the lining of the duodenum as a result of this condition. Some of the symptoms can include pain after eating, nausea, and vomiting.
An EGD with the use of biopsies is a test that is considered the gold standard for diagnosing EG/EoD. During this test, a flexible tube with a camera on the end is inserted into the mouth and down into the esophagus. In this way, the esophagus, stomach, and duodenum (first part of the small intestine) can be seen. Several biopsies (small pieces of tissue) are taken from different points in the digestive tract for use in diagnosing EG/EoD.
This diet can take one of several forms, including the 2-, 4-, and 6-food elimination diets. Anywhere between 2 and 6 foods that are potentially causing an allergic response are eliminated from the diet. These diets may be helpful in some cases of EG/EoD, but they need to be used under guidance from a dietitian in order to avoid any vitamin or mineral deficiencies.
Eosinophils are a type of white blood cell. The purpose of an eosinophil is to protect the body from infections and disease. While eosinophils are normally present in the lining of the digestive system, but they are found in higher than normal amounts in people diagnosed with EG/EoD.
Mast cells help protect the body from viruses, parasites, and bacteria. Mast cells can either kill invaders or start an inflammatory response. It’s thought that this inflammatory response might be part of the development of EG/EoD. Medications called mast cell stabilizers, which prevent mast cells from releasing chemicals, may be used in treating EG/EoD.