Causes and Symptoms of Eosinophilic Gastritis and/or Eosinophilic Duodenitis

Many of the signs and symptoms are nonspecific

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Eosinophilic gastritis and/or eosinophilic duodenitis (EG/EoD), previously often called eosinophilic gastroenteritis, affects the digestive system. The inflammation caused by the disease can lead to a range of symptoms.

This article will discuss the causes of EG/EoD, its symptoms and complications, and when to see a doctor.

Eosinophilic Gastritis and/or Eosinophilic Duodenitis Complications

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Scientists don’t know exactly what causes some people to develop EG/EoD. What is known is that about half of all people who live with the disease also have a history of allergies. For that reason, it’s thought that having a personal or a family history of allergies increases your risk of developing the condition. These allergies can be from food or environmental factors.

Another theory is that this disease is related to a chronic Th2-type immune response. Some white blood cells primarily produce proteins called Th2 cytokines. They are messenger proteins that help cells communicate with one another. They attract and stimulate the production of a type of disease-fighting white blood cell called eosinophils.

Endoscopies with biopsies that evaluate the volume of eosinophils present in the digestive tract can be taken to diagnose EG/EoD. The chronic overproduction of eosinophils and overpopulation in these tissues causes inflammation in the digestive tract.

The inflammation can damage the digestive tract and cause symptoms that are common with EG/EoD. More studies are underway to understand the causes of—and the best treatments for—this disease.

Frequent Symptoms

The symptoms of EG/EoD can be nonspecific. That is, they can often be similar to those of other diseases and conditions of the digestive system.

This means that the disease is not diagnosed based on symptoms alone. Rather, the symptoms, a history of allergies, and the results of a physical exam and an endoscopy and biopsy procedure are used to make the diagnosis.

Symptoms will be different from person to person, with some being more commonly reported than others. These include:

Rare Symptoms

Other symptoms of EG/EoD are less common and depend on the area of the disease within the body and how widespread it is. Some of the symptoms that are reported less often are:


The signs and symptoms of EG/EoD and the progression of the disease can lead to complications. Because this condition can affect any part of the digestive system, the possible complications are fairly broad. However, there are a few that may be more common than others:

  • Small bowel obstruction: EG/EoD can cause swelling on the inside of the intestines, which leads to less space for digesting food to move through. When the food gets stuck, it can block the intestine.
  • Anemia: When there is bleeding in the digestive tract it can lead to anemia. Anemia is a lack of enough red blood cells or hemoglobin in the body. It can cause symptoms such as fatigue, dizziness, pale skin, rapid heartbeat, and shortness of breath.
  • Food impaction: A difficulty in swallowing can lead to food becoming impacted (stuck) in the esophagus.
  • Unintended weight loss: Weight loss can be troubling, especially in children. Having symptoms such as abdominal pain or a lack of appetite can lead to weight loss for some people who live with EG/EoD.
  • Protein-losing enteropathy: This condition is the loss of protein in the intestines. The inflammation that EG/EoD causes in the intestines can lead to this complication, which is uncommon but can be serious and cause other problems like an increased risk of infection.
  • Ascites: This is the buildup of fluid in the abdomen, which causes swelling. It’s a sign of EG/EoD and also a complication because the fluid might need to be drained.
  • Steatorrhea: This is the presence of extra fat in the stool because it is not being absorbed in the intestines. Stool with high levels of fat in it may look oily or greasy and may float in the toilet. Losing too much fat can contribute to weight loss and malnutrition.

More rare complications have also been reported. There are few big studies on EG/EoD and much of the published information is in the form of case reports—a write-up of a single patient (or sometimes a few patients). Some of the more uncommon complications that have been observed include:

When to Go to the Emergency Department

It can be challenging to know when to call the doctor and when to go to emergency or urgent care to be seen right away. It's a good idea to ask about "red flag" symptoms from the healthcare professionals that are treating the disease, especially during a flare-up or when starting a new treatment.

For instance, passing out or experiencing severe abdominal pain that comes on quickly are two reasons to seek care right away.

When to See a Doctor

EG/EoD is a difficult disease to diagnose and treat. This is partly because the symptoms are so nonspecific, and only recently has research shed light on updated testing methods that can lead to proper diagnosis.

In some cases, it takes years before patients get a diagnosis. For this reason, many people ultimately diagnosed with EG/EoD will see several different healthcare professionals, including specialists like gastroenterologists, over a period of time.

There are, however, some signs and symptoms that should not be ignored because they may indicate a complication that could be serious or even life-threatening. Check with a doctor if any of the following occur:

  • Abdominal swelling
  • Chest pain
  • Fainting
  • Dizziness
  • Rectal bleeding
  • Severe abdominal pain
  • Severe constipation
  • Vomiting that won’t stop


The causes of EG/EoD are unclear, but this condition is associated with food and environmental allergies and an excessive volume of white blood cells called eosinophils. The symptoms are nonspecific and may include abdominal pain, bloating, diarrhea, fatigue, nausea, and vomiting. If not controlled, the condition can lead to complications such as anemia and digestive tract obstruction.

A Word From Verywell

EG/EoD unfortunately is not well understood. The exact causes are still not known, and treatments are mostly geared toward relieving symptoms. It’s important to control the inflammation that the disease causes so it does not lead to other complications.

People living with this condition are often diagnosed only after a long period of time of living with the symptoms, and they may even have been misdiagnosed for conditions like IBS or acid reflux in the past. It’s important to continue with treatments and to see a healthcare provider on a regular basis to help keep inflammation under control.

Seeing your healthcare team regularly also is a good way to learn of any new studies or medical advances that might lead to improved treatments.

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  1. Uppal V, Kreiger P, Kutsch E. Eosinophilic gastroenteritis and colitis: a comprehensive review. Clin Rev Allergy Immunol. 2016 Apr;50(2):175-88. doi:10.1007/s12016-015-8489-4

  2. Gurram RK, Zhu J. Orchestration between ILC2s and Th2 cells in shaping type 2 immune responses. Cell Mol Immunol. 2019 Mar;16(3):225-235. doi:10.1038/s41423-019-0210-8

  3. Allakos. Lirentelimab (AK002) targets Siglec-8, an inhibitory receptor found on the surface of mast cells and eosinophils. 2021.

  4. Reed C, Woosley JT, Dellon ES. Clinical characteristics, treatment outcomes, and resource utilization in children and adults with eosinophilic gastroenteritis. Dig Liver Dis. 2015;47:197-201. doi:10.1016/j.dld.2014.11.009

  5. Pineton de Chambrun G, Gonzalez F, Canva JY, et al. Natural history of eosinophilic gastroenteritis. Clin Gastroenterol Hepatol. 2011;9(11):950-956.e1. doi:10.1016/j.cgh.2011.07.017

  6. Genetic and Rare Diseases Information Center (GARD). Eosinophilic gastroenteritis. August 18, 2020. 

  7. Zhang M, Li Y. Eosinophilic gastroenteritis: A state-of-the-art review. J Gastroenterol Hepatol. 2017;32(1):64-72. doi:10.1111/jgh.13463

  8. Peterson KA, Genta RM, Kamboj AP, Singh B, Rasmussen HS, Dellon ES. S1330 high discovery rate of previously undiagnosed patients with eosinophilic gastritis and duodenitis using a systematic endoscopic biopsy protocol: screening data analysis from enigma, a randomized controlled trial. Am J Gastroenterol. 2020;115(1):S669-S670.