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. 2018 Jul-Aug;31(4):475-479.
doi: 10.20524/aog.2018.0263. Epub 2018 Apr 27.

Eosinophilic gastrointestinal disorder: is it what it seems to be?

Stefania Chetcuti Zammit  1 , Monique Cachia  2 , Karen Sapiano  2 , Julia Gauci  2 , Stephen Montefort  3 , Pierre Ellul  1
Affiliations

Eosinophilic gastrointestinal disorder: is it what it seems to be?

Stefania Chetcuti Zammit et al. Ann Gastroenterol. 2018 Jul-Aug.

Abstract

Background: Eosinophilic gastroenteropathy is an uncommon condition whose causes can be numerous and non-specific. The aim of the study was to characterize the presence of gastrointestinal disorders in the adult Maltese population and assess the degree of association with atopic diseases.

Methods: Adult patients with gastrointestinal eosinophilia in the gastrointestinal tract on histology were identified and their clinical case notes were reviewed. Patients were interviewed and asked questions regarding asthma, allergic rhinitis, and eczema.

Results: Sixty-six patients (39 female) were recruited. The most common clinical symptoms were diarrhea (42.4%) and abdominal pain (33.3%). The sites involved were stomach (10.6%), colon (56.1%), small bowel (10.6%), small bowel and colon (18.2%), esophagus (1.5%), and esophagus and colon (1.5%). Forty percent had persistent lower gastrointestinal symptoms and a repeat ileocolonoscopy was performed within 12 months. These patients were diagnosed with ulcerative colitis (n=10; 47.6%), Crohn's disease (n=6; 28.6%), indeterminate colitis (n=1; 4.8%) or microscopic colitis (n=4; 19%). Allergic rhinitis was present in 39.4% of the study group, eczema in 26.1%, and asthma in 19.7%. These findings were compared with local data for atopic conditions and the study group was found to have a significantly higher prevalence of allergic rhinitis (P=0.002), but not of asthma (P=0.62) or eczema (P=0.19).

Conclusions: A high proportion of patients with eosinophilic gastrointestinal infiltration were subsequently diagnosed with inflammatory bowel disease. Patients persistently symptomatic or who do not respond to treatment should be reassessed to exclude inflammatory bowel disease, given its high prevalence in this group of patients.

Keywords: Crohn’s disease; Eosinophilic esophagitis; eosinophilic gastrointestinal disorders; inflammatory bowel disease; ulcerative colitis.

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Figures

Figure 1
Figure 1
Presenting symptoms vs. percentage of patients
See this image and copyright information in PMC

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