Eosinophilic gastroenteritis (EGE) is defined by eosinophilic infiltration of the mucosa, muscular layer, or subserosal tissue of any segment of the gastrointestinal (GI) tract from the mouth to anus in the absence of another explanation for the eosinophilia. Most commonly, EGE is distributed in the stomach and small intestine. It is a rare and chronic GI disorder with no known etiology that can present at any age, but is most often diagnosed between the third and fifth decades of life. Approximately half of patients have a personal or family history of atopy defined as food sensitivities, eczema, or rhinitis.
EGE presents with nonspecific symptomatology and is a difficult diagnosis to distinguish from other causes of GI inflammation or malabsorption. The symptom profile varies depending on the depth of eosinophil infiltration:
Mucosal disease (most common) – Abdominal pain, nausea, diarrhea, vomiting. Malabsorption with micronutrient deficiency, anemia, and protein-losing enteropathy.
Muscular layer infiltration – Bowel obstruction due to intestinal wall thickening.
Subserosal disease (least common) – Ascites not explained by another mechanism and symptoms of mucosal and muscular layer disease.