Eosinophilic gastroenteritis: A state-of-the-art review

• Published in: Journal of gastroenterology and hepatology 2017-01, Vol.32 (1), p.64-72
• Main Authors: Zhang, MingMing, Li, YanQing
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - therapeutic use; Allergens; Colitis; Corticosteroids; Endoscopy; Enteritis; Enteritis - diagnosis; Enteritis - epidemiology; Enteritis - etiology; Enteritis - pathology; Eosinophilia - diagnosis; Eosinophilia - epidemiology; Eosinophilia - etiology; Eosinophilia - pathology; Eosinophils - pathology; Esophagitis; Gastritis; Gastritis - diagnosis; Gastritis - epidemiology; Gastritis - etiology; Gastritis - pathology; Gastroenteritis; Gastrointestinal diseases; Gastrointestinal tract; Gastrointestinal Tract - pathology; Humans; Leukocytes (eosinophilic); Mucosa; Pathophysiology; Surgery
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/jgh.13463

Eosinophilic gastrointestinal disorders are a series of diseases that include eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis, eosinophilic enteritis, and eosinophilic colitis. Among these disorders, eosinophilic gastroenteritis is an uncommon and heterogeneous disease characterized by eosinophilic infiltration of the gastrointestinal tract in the absence of secondary causes, presenting with a variety of gastrointestinal manifestations. Up to now, epidemiology and pathophysiology of eosinophilic gastroenteritis are still unclear. Based on clinical manifestations and depth of eosinophilic infiltration into the gastrointestinal tract wall, eosinophilic gastroenteritis is classified into three different patterns including predominantly mucosal pattern, predominantly muscular pattern, and predominantly serosal pattern. For diagnosing eosinophilic gastroenteritis, it is necessary for clinicians to have a high degree of clinical suspicion. In addition to the gastrointestinal symptoms, other evidences such as laboratory results, radiological findings and endoscopy can also provide important diagnostic evidences for eosinophilic gastroenteritis. And these indirect pieces of information together with histological results will lead to a definitive diagnosis of eosinophilic gastroenteritis. To avoid specific allergen, dietary treatments can be considered as initial treatment strategy before drug treatment. Corticosteroids are the main medication for eosinophilic gastroenteritis and have a dramatic therapeutic efficacy. Yet other medications need to further verify their effects in clinical practice, and surgery should be avoided as far as possible.