What is Eosinophilic Gastroenteritis?

Eosinophilic Gastroenteritis (EG) is still a fairly rare disease; however it has become more prevalent within the past few years. EOS, as it is sometimes called, can actually be classified as a blood disorder, even though the affected part of this disease is the gastro-intestinal tract. Eosinophils are a normal part of the body’s defense system, and when the body senses an intruder it will react by immediately sending eosinophils through the blood stream to attack the intruder and protect the body.

With Eosinophilic Gastroenteritis, or EG, something has gone wrong and the body is sensing certain foods as harmful intruders, setting off the immune system response. The eosinophils hit the stomach, small intestine, or colon (depending on where this person is sensitive or reactive), can’t really find any true invaders and ends up turning in to the gastrointestinal wall.

Eosinophils are highly effective defenders of the body, so when they attack the intestinal wall, they do some damage. This will produce the symptoms associated with Eosinophilic Gastroenteritis, which are usually pain, vomiting, nausea, vomiting, diarrhea, weight loss, and abdominal distension. The eosinophils can penetrate the gastrointestinal system to different depths, depending on the severity. Over time, the villi in the intestine, which is what absorbs the nutrients into the body from the food we eat, can be completely destroyed.

Diagnosis

EOS is very hard to get a definitive diagnosis, and many people spend years trying to find out what is wrong with them, or their children. The biggest obstacle to a good diagnosis is that a lot of doctors out there just do not know about Eosinophilic Gastroenteritis, Eosinophilic Esophagitis (EE), or hypereosinophilic syndrome, and therefore misread symptoms and are reluctant to order an endoscopic procedure, which is the only way to get an actual clinical diagnosis. The GI tract is “scoped” and samples taken at different points along the way. These samples (biopsies) are then examined for Eosinophilic concentrations (they are counted) and a determination is made on an EG diagnosis.  

Treatment

There is no cure. Treatment is to avoid eating the foods that cause a reaction, which is the standard protocol for food allergies as well. However, some have only a handful of foods that are tolerable (don’t cause reactions) and some EG patients simply can’t eat anything at all. In these cases, supplementation with, or a simple diet of an elemental amino acid based food supplement is needed. The two major brands on the market today are Neocate and Elecare. They are expensive and most insurance companies won’t pay for them unless the patient has been G-tubed.

For infants, these formulas can be administered through a bottle, but as children get older the bottle is no longer acceptable. Some can make the transfer to cups, using straws or flavoring in the drink to make it palatable, but for others the G-tube feeding tube is the only alternative to getting the nutrients needed for life.

Corticosteroids are also an option, with some patients responding well to treatment, however, long term steroid use has its own set of side effect symptoms as well. Drugs and other treatments for EOS disorders are still in the research stages, and avoidance to reactive foods is still the best option. For many patients, their only source of nutrients is their Neocate!

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