Causes and Symptoms of Eosinophilic Gastritis and/or Eosinophilic Duodenitis

Many of the signs and symptoms are nonspecific

Eosinophilic gastritis and/or eosinophilic duodenitis (EG/EoD), previously called eosinophilic gastroenteritis, is an inflammatory disease of the digestive system that can lead to a range of symptoms.

Because it's not common, many people who have EG/EoD may be misdiagnosed with conditions such as irritable bowel syndrome (IBS) or acid reflux before the disease is diagnosed. The exact causes of EG/EoD are still not known, and there is no cure. The treatments are usually geared toward relieving symptoms. 

Eosinophilic Gastritis and/or Eosinophilic Duodenitis Symptoms

Julie Bang / Verywell

When you have gastrointestinal problems, it can be challenging to push for more testing, especially if you've already been through invasive procedures. Typically, EG/EoD is diagnosed with an upper endoscopy (EGD), during which the doctor can see the lining of the digestive system and take a sample for a biopsy. The biopsy may show high levels of eosinophils (a type of immune cell) in the lining of the digestive tract.

Recent research is shedding more light on EG/EoD. The condition is likely more common than originally thought, and there is research being done that might lead to more effective management.

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


The lining of the digestive tract (the mucosa) normally contains a small amount of a type of white blood cell called eosinophils. Eosinophils help in protecting the digestive system from harmful substances, such as allergens or organisms that cause infection. EG/EoD is characterized by excessive eosinophils in these tissues. This causes inflammation in the digestive tract.

The eosinophils produce small proteins called cytokines and eotaxins. These substances may also play a role in the inflammation that occurs in the digestive system with EG/EoD.

The exact cause of EG/EoD and its progression is not well understood. Some people with this condition also have hypersensitivity reactions (atopy), seasonal allergies, food allergies, asthma, and a higher than normal level of an antibody called immunoglobulin E (IgE) in their blood. The connection to allergic disease suggests that this may play a role in the development of EG/EoD.

Another theory is that food allergens may cross the mucosa in the digestive system, leading to an increase in the eosinophils.

Frequent Symptoms

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

Symptoms can vary and include:

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.

Rare Symptoms

Less common symptoms of EG/EoD depend on which areas of the digestive system are affected and how widespread it is.

Some less common symptoms include:


Eosinophilic Gastritis and/or Eosinophilic Duodenitis Complications

Julie Bang / Verywell

The effects 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 inside of the intestines, which decreases the space that food can move through as it's being digested. When the food gets stuck, it can block the intestine.
  • Anemia: Bleeding in the digestive tract can lead to anemia. Anemia is a deficiency of red blood cells or hemoglobin in the body. It can cause symptoms such as fatigue, dizziness, pale skin, rapid heartbeat, and shortness of breath.
  • Unintended weight loss: Abdominal pain or a lack of appetite can lead to weight loss for some people who have EG/EoD.
  • Protein-losing enteropathy: The inflammation that EG/EoD causes in the intestines can prevent protein from being absorbed by the intestines. This is uncommon, but it can be serious and may cause other problems, like an increased risk of infection.
  • Ascites: A buildup of fluid in the abdomen may cause swelling. It’s a sign of EG/EoD, and the fluid might need to be drained with a procedure.
  • Steatorrhea: Fat can be present in the stool when it is not absorbed in the intestines. Stool that has 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.

Some of the rare complications that have been observed include:

When to See a Doctor

If you have intermittent or worsening gastrointestinal symptoms, it's important that you talk to your doctor and describe your symptoms.

In some cases, it takes years to get a diagnosis of EG/EoD. Many people who have this condition will see several different healthcare professionals, including specialists like gastroenterologists, over a period of time before getting the right diagnosis.

As you are being evaluated, pay close attention to how your symptoms respond to dietary changes or medical treatments, as these observations can help guide your doctors to your diagnosis and to the most effective treatment for you.

When to Go to the Emergency Department

Certain signs and symptoms should not be ignored because they may indicate a complication that could be serious or even life-threatening.

Check with a doctor if you experience any of the following:

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

To prepare for your appointment with a healthcare provider, use our downloadable Doctor Discussion Guide below. It'll help you learn relevant terminology, anticipate questions you may want to ask, and more.


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

10 Sources
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  1. Peterson KA, Genta RM, Kamboj AP, Singh B, Rasmussen HS, Dellon ES. 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. Poster presented at: American College of Gastroenterology Annual Scientific Meeting; October 26-28, 2020. P2797.

  2. Shoda T, Wen T, Caldwell JM, et al. Molecular, endoscopic, histologic, and circulating biomarker-based diagnosis of eosinophilic gastritis: Multi-site study. J Allergy Clin Immunol. 2020;145(1):255-269. doi:10.1016/j.jaci.2019.11.007.

  3. 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

  4. 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

  5. Rank MA, Sharaf RN, Furuta GT, et al. Technical review on the management of eosinophilic esophagitis: A report from the AGA institute and the joint task force on allergy-immunology practice parameters. Gastroenterology. 2020;158(6):1789-1810.e15. doi:10.1053/j.gastro.2020.02.039.

  6. Mori A, Enweluzo C, Grier D, Badireddy M. Eosinophilic gastroenteritis: review of a rare and treatable disease of the gastrointestinal tract. Case Rep Gastroenterol. 2013;7(2):293-298. doi:10.1159/000354147.

  7. 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

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

  9. 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

  10. 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.

By Amber J. Tresca
Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16.