Eosinophilic Gastrointestinal Diseases Beyond Eosinophilic Esophagitis.

The eosinophilic gastrointestinal diseases (EGIDs) are chronic, immune-mediated conditions characterized clinically by GI symptoms and histologically by pathologic infiltration of the GI tract by eosinophils. The most well-studied is eosinophilic esophagitis (EoE), but non-EoE EGIDs are becoming more frequently encountered. These have traditionally been classified by the predominant location inflammation, including eosinophilic gastritis (EoG; stomach only), eosinophilic enteritis (EoN; small bowel only), and eosinophilic colitis (EoC; colon only).(1, 2) However, multiple locations can be involved (e.g. gastric and small bowel involvement), specific segments of the small bowel can be named (e.g. eosinophilic duodenitis; EoD), and efforts are underway to standardize this nomenclature. The non-EoE EGIDs are considered rare diseases, with studies of administrative databases estimating the prevalence to be approximately 3–8/100,000, or ~50,000 cases in the United States.(3) However, recent data suggest these conditions may be under diagnosed.(4) In this paper, I will review my approach to the diagnosis and management of the non-EoE EGIDs, highlighting a number of principles that can be applied in most settings.