Eosinophilic Colitis

Eosinophilic colitis (EoC) is a rare inflammatory disorder that affects your colon (large intestine). It happens when white blood cells called eosinophils build up in the lining of your colon. This buildup causes swelling and irritation (inflammation).

EoC is a type of eosinophilic gastrointestinal disease (EGID). It can be serious because the inflammation can lead to ongoing symptoms. You may have weight loss, diarrhea or belly pain that doesn’t go away. In more severe cases, it can affect how your intestines work. It can lead to problems like blockages and trouble getting enough nutrients.

Eosinophilic colitis (pronounced “ee-uh-sin-uh-FIL-ik kuh-LAHY-tis”) is often a long-term (chronic) condition, but it’s manageable. Treatment focuses on lowering inflammation and easing your symptoms. You may need to change what you eat or take medicine. Many people feel better with treatment, but symptoms can come and go.

Eosinophilic colitis symptoms

Symptoms can vary, but common ones include:

• Chronic diarrhea that may contain blood
• Abdominal (belly) pain or cramping
• Blood or mucus in your poop
• Nausea or vomiting
• Weight loss or trouble gaining weight

In more severe cases, symptoms may include:

• Bloating or a swollen belly
• Signs of a blockage in your intestines (rare)

Eosinophilic colitis causes

Researchers don’t fully understand the exact cause. They believe it’s linked to how your immune system reacts.

Possible causes or triggers include:

• Food-related immune reactions (more common in infants)
• Medications, like certain anti-inflammatory drugs

Risk factors

You may be more likely to develop eosinophilic colitis if you:

• Have allergies, asthma or eczema
• Have a history of food sensitivities
• Take certain medications linked to inflammation

Some forms of EoC are more likely to affect infants and young children.

Complications of this condition

Without treatment, eosinophilic colitis may lead to:

• Chronic symptoms
• Poor nutrition or weight loss
• A long-term condition with flare-ups
• Intestinal blockage (rare)

If your symptoms don’t improve, your provider may check for signs of inflammatory bowel disease.

How doctors diagnose this condition

To diagnose eosinophilic colitis, your healthcare provider will ask about your symptoms. They’ll try to rule out other conditions. Then, they’ll order a colonoscopy with a biopsy. During this test, your provider:

• Uses a thin tube with a camera to look at your colon
• Takes small tissue samples

After the test, your provider sends the samples to a lab. A pathologist checks them under a microscope to look for high levels of eosinophils.

Your colon may look normal during a colonoscopy. But a biopsy can still show inflammation. There’s no universal cutoff number of eosinophils that confirms the condition. So, your provider will make the diagnosis based on test results and by ruling out other causes.

Your provider may also order:

• Blood tests to check eosinophil levels
• Poop tests to rule out infections

How is eosinophilic colitis treated?

There’s no single cure for eosinophilic colitis, but treatment can help you manage your symptoms. Treatment depends on your age and how severe your symptoms are.

If your infant has EoC, their symptoms may improve after you make changes to what they eat. This often means removing foods like cow’s milk or soy.

For older children and adults, an elimination diet may help find trigger foods. Your provider may also prescribe certain medicines, like corticosteroids, to reduce inflammation. If symptoms are severe or don’t improve, you may need other medications.

Your provider will tailor your care to your needs, and your care plan may change over time.

Recovery time

Recovery is different for everyone. Some infants improve within weeks after making changes to what they eat. Older children and adults may need longer treatment. Symptoms may come and go over time.

When should I see my healthcare provider?

Talk to your provider if you have:

• Ongoing diarrhea
• Blood in your poop
• Unexplained weight loss
• Frequent belly pain

Seek care sooner if symptoms are severe or don’t improve with treatment.

What can I expect if I have this condition?

Eosinophilic colitis is rare, and it doesn’t affect everyone the same way. Some people, especially infants, get better with simple treatment. Others may have a long-term condition with flare-ups. Most people can manage symptoms with the right treatment plan.