Eosinophilic Gastritis

What is eosinophilic gastritis?

Eosinophilic gastritis (EG) is a rare disease that affects your stomach. A type of white blood cell (eosinophils) builds up, causing inflammation (swelling) and damage.

EG can affect anyone at any age. It's a chronic (long-term) disease. But your healthcare provider can help you manage symptoms with regular testing and diet changes.

What are eosinophils?

Eosinophils (ee-oh-sin-oh-fills) are one of several types of white blood cells that support your immune system. Your bone marrow (soft tissue inside bones) normally produces a small number of eosinophils. In a healthy person, they represent about 1% to 5% of white blood cells.

Allergens, infections, medications or cancer can cause eosinophils to increase (eosinophilia). They also release substances (enzymes and proteins) to destroy unhealthy cells.

When your body produces too many eosinophils, you can develop inflammation in the tissues of your stomach (gastritis) or other organs.

Who is affected by eosinophilic gastritis?

Eosinophilic gastritis affects people of all ages. Healthcare providers most often diagnose EG in adults between ages 30 and 50. Slightly more people assigned male at birth than people assigned female at birth develop the disease.

You may be at higher risk of developing EG if you have a history of allergic disorders or a family member with a related disease. People who develop EG often have allergic conditions such as:

• Asthma.
• Food intolerance or food allergies.
• Hay fever (allergic rhinitis).
• Runny nose (rhinitis).
• Skin rash (eczema).

What are the types of eosinophilic gastrointestinal disorders?

Eosinophilic gastritis is one type of eosinophilic gastrointestinal disease (EGID). These conditions can affect different parts of your digestive system. You may have more than one disorder at once (which happens when you have high numbers of eosinophils).

The six main types of EGID include:

• Eosinophilic colitis (EC) involves your large intestine (colon).
• Eosinophilic duodenitis affects the first part of your small intestine.
• Eosinophilic enteritis (EoN) affects your small bowel.
• Eosinophilic esophagitis (EoE), the most common EGID, involves your esophagus.
• Eosinophilic gastritis (EG) involves your stomach.
• Eosinophilic gastroenteritis (EGE) primarily affects your stomach and small intestine.

Other types of eosinophilic disease that can affect your GI system are:

• Hypereosinophilic syndrome involves the blood and any organ.
• Eosinophilic granulomatosis with polyangiitis (EGPA) can affect many organs, including your heart.

How common is eosinophilic gastritis?

Healthcare providers believe that eosinophilic gastritis is a relatively rare disease. However, it's likely underdiagnosed because EG symptoms are like symptoms of many other conditions.

What causes eosinophilic gastritis?

Healthcare providers don’t always know the exact cause of eosinophilic gastritis. In most cases, people develop EG due to an abnormal immune system response to certain foods.

What are the symptoms of eosinophilic gastritis?

Signs of eosinophilic gastritis are usually mild or moderate. Common symptoms include:

• Abdominal pain or fluid buildup (ascites).
• Diarrhea.
• Difficulty eating (loss of appetite) or swallowing (dysphagia).
• Fatigue.
• Heartburn.
• Low levels of healthy red blood cells (anemia).
• Nausea and vomiting.
• Weight loss or poor growth.

How is eosinophilic gastritis diagnosed?

It can take a while to diagnose eosinophilic gastritis due to its common symptoms. It is typically diagnosed based on blood work (high eosinophil count), changes in the stomach on endoscopy and looking at tiny specimens from the stomach under the microscope. If the increased eosinophils are present in the deeper layers of the stomach wall rather than the superficial lining, it might be hard to see those eosinophils with simple biopsies and it can take longer to diagnose the disease.

To diagnose EG, your healthcare provider:

• Does a physical exam.
• Asks you about your medical history.
• Orders blood tests, including a complete blood count, to detect abnormalities and help rule out other conditions.

What tests help diagnose eosinophilic gastritis?

Other tests your healthcare provider may order include:

• Upper endoscopy can confirm an EG diagnosis. Your provider uses a small tube with a tiny camera to examine parts of your stomach, esophagus and small intestine. Your provider also looks for swelling, irritation or injury to your stomach.
• Biopsy is when your healthcare provider removes a small tissue portion to confirm a diagnosis. A biopsy occurs during an endoscopy. After the biopsy, a pathologist analyzes the samples in a laboratory. If the eosinophil count is higher than the normal count, this can indicate eosinophilic gastritis.
• Allergy testing helps identify allergens in food that may cause an increase in eosinophils in your stomach. Knowing the allergens can help guide diagnosis and treatment.

Is there a cure for eosinophilic gastritis?

Eosinophilic gastritis has no cure, but medications or dietary changes can help you manage symptoms. Following treatment guidelines can help you lead an active, healthy life.

Is eosinophilic gastritis life-threatening?

Eosinophilic gastritis doesn’t require emergency medical attention. Early diagnosis and treatment can help prevent severe complications such as malnutrition, especially in infants and children.

What is the treatment for eosinophilic gastritis?

Healthcare providers treat eosinophilic gastritis using diet and medications to manage the underlying cause and its symptoms. EG treatment depends on your symptoms and disease severity.

Your provider may recommend dietary changes to prevent food allergens from triggering eosinophilic gastritis symptoms. These may include:

• Elimination diet removes certain foods from your diet that can cause allergic reactions.
• Elemental diet replaces food with nutrition from a special liquid formula.

Your infant may need a new type of baby formula to ease EG symptoms. In some cases, children and adults need to take iron supplements.

You may also receive medications:

• Corticosteroids (such as prednisone or budesonide) to reduce swelling.
• Immunosuppressants (such as azathioprine) to decrease the immune system's reactions.

How can I reduce my risk of developing eosinophilic gastritis?

Your ability to reduce your risk of developing eosinophilic gastritis depends on the underlying condition. Allergies are the most common cause of high eosinophil levels.

Dietary changes and medication can help prevent or control your immune system's allergic reactions. A healthy diet and lifestyle can help reduce your overall risk of disease. Talk to your healthcare provider if you have allergies or a family history of EG.

What’s the outlook for eosinophilic gastritis?

For most people, the outlook for eosinophilic gastritis is generally good, though it's a chronic condition where patients can experience flare ups of the disease. Your healthcare provider works with you throughout your life to manage eosinophilic gastritis and ease your symptoms.

You receive regular endoscopies and biopsies to check on your condition. Monitoring helps your provider adjust treatment, if needed, so you or your child can avoid complications. Follow your provider's guidelines and keep medical appointments to ensure timely care.

Will eosinophilic gastritis affect my quality of life?

The degree to which EG impacts your life depends on the severity of your symptoms, any underlying condition and treatment success. In most cases, having eosinophilic gastritis means adjusting your diet to avoid food allergens and possibly taking medication.

For many people, dietary changes can mean physical and emotional challenges. It may be difficult at first to plan around meals and social occasions. You may not be able to eat some of your favorite foods. But by following treatment guidelines and seeking support when you need it, you can feel better and stay active.

When should I seek care for eosinophilic gastritis?

Seek care for eosinophilic gastritis when you feel stomach pain or symptoms that get worse. Talk with your provider about your symptoms and how they respond to dietary changes or medication. Your provider may refer you to a GI specialist called a gastroenterologist.

A note from Cleveland Clinic

Eosinophilic gastritis (EG) is a rare, long-term disease that affects your stomach. It often takes time to confirm a diagnosis, since its symptoms so closely resemble those of other common diseases. While there's no cure, medication or dietary changes can help ease symptoms. Your healthcare provider works closely with you to maximize treatment and your quality of life.