• Eosinophilic Gastritis—Child

    Definition

    Eosinophilic gastritis (EG) is a buildup of white blood cells called eosinophils in the stomach. EG can lead to inflammation, tissue damage, ulcers, and polyps. This can make it hard for the body to get enough nutrients from food.
    EG may occur in cycles. Symptom may fade or stop for a time, then they may flare up again.

    Cause

    It is not clear what causes EG. It is likely due to a blend of genetics and the environment.
    Eosinophils are part of the immune system response to problems in the body. Part of their normal function is to cause inflammation that helps trap harmful material. With EC, eosinophils build up when it is not needed or remains longer than needed and causes unnecessary inflammation. It is not clear what causes the buildup. It may be linked to the presence of an allergen.

    Risk Factors

    Factors that may increase your child’s chances of EG include:
    • Genetic problems
    • Family members with allergies or asthma
    • Food allergies
    • Seasonal allergies
    • Atopic dermatitis
    • Other eosinophilic gastrointestinal diseases

    Symptoms

    Symptoms may include:
    • Severe abdominal pain
    • Abdominal swelling
    • A feeling of fullness after eating a small amount
    • Heartburn
    • Nausea
    • Vomiting
    • Diarrhea, with or without blood
    • Fatigue
    • Problems feeding in infants
    Complications may include:
    • Malnutrition
    • Weight loss
    • Anemia or iron deficiency from blood loss

    Diagnosis

    You will be asked about your child’s symptoms and medical history. A physical exam will be done. EG is hard to diagnose with simple tests. However, some tests may be able to rule out other diseases with similar symptoms.
    Tests to rule out other conditions include:
    • Blood tests
    • Allergy tests
    • Endoscopy—a lighted tube with a camera is used to view the stomach lining
    A biopsy is the only way to confirm EG. During a biopsy, tissue samples from an endoscopy are examined under a microscope to confirm a diagnosis
    Upper GI Endoscopy
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    Treatment

    Treatment focuses on managing symptoms and decreasing damage to the stomach. Treatment options may include:

    Dietary Changes

    Foods that cause symptoms will need to be avoided. For some people, removing milk and soy will resolve symptoms. This is often true for infants.
    Proteins, such as soy, nuts, eggs, or milk are common allergens. A dietitian can help with meal planning.
    Other changes may include:
    • If all proteins need to be removed, then only the building blocks called amino acids can be consumed. Liquid formulas may be needed. In some cases, a feeding tube may be used.
    • A nutritional support program may be needed to support growth. This may include vitamins and supplements.

    Medications

    Medications are used to manage EG. These may include:
    • Oral steroids to reduce inflammation during symptom flare ups
    • Medications to boost, change, or suppress immune system effects
    Medications are also used to treat complications. These may include:
    • Medications to reduce stomach acid
    • Iron pills to treat anemia
    Medications to manage allergies or asthma may also be needed.

    Surgery

    If the opening from the stomach to the small intestine becomes too narrow or blocked, then surgery will be needed to fix it.

    Prevention

    There are no current guidelines to prevent EG because the cause is not clear.

    RESOURCES

    American Partnership for Eosinophilic Disorders http://apfed.org

    Healthy Children—American Academy of Pediatrics https://www.healthychildren.org

    CANADIAN RESOURCES

    Canadian Association of Gastroenterology https://www.cag-acg.org

    Sick Kids—The Hospital for Sick Children http://www.sickkids.ca

    References

    About eosinophilic gastritis (EG). The Southeast Eosinophilic Disease Center of Atlanta, Inc. website. Available at: https://www.seedcenteratl.org/about-eosinophilic-gastritis-eg. Accessed June 15, 2017.

    Eosinophilic gastritis. American Partnership for Eosinophilic Disorders website. Available at: http://apfed.org/about-ead/egids/eg. Accessed June 15, 2017.

    Eosinophilic gastritis. EoE Resource website. Available at: http://www.eosinophilicesophagitisresource.org/eosinophilic-gastritis. Accessed June 15, 2017.

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