Eosinophilic gastroenteritis is relatively newly discovered disease

1. DR. K. K. RAWAL
M.D. D.M.(GASTRO)
Consultant Gastroenterologist
Milestone Hospital
Vidyanagar main road
Rajkot (0281-2480843 / 44)

2.  ESOPHAGITIS
 GASTRITIS
 ENTERITIS
 COLITIS

3.  ABNORMAL GI SYMPTOMS (PAIN, DIARRHEA)
 EOSINOPHILIC INFILTRATION > 20 / hpf
 INFILTRATION LIMITEDTO GIT ONLY
 NO KNOWN CAUSE OF EOSINOPHILIA
80 % PERIPHERAL EOSINOPHILIA
50 % ATOPY (ASTHMA,FOOD ALLERGY)

4.  M>F
 PEAK – 20TO 50YEARS
MATHAN (1998 IJG)

5.  CYTOKINES (IL-3,IL-4,IL-13)
 LEUKOTRIENE (C4)
 CHEMOKINES

6.  MUCOSAL FORM
 MUSCULAR FORM
 SEROSAL FORM
OVERLAP POSSIBLE

7. ALLERGY MOST COMMON
 VOMITING,ABDOMINAL PAIN
 DIARRHEA, MALABSORPTION
 BLOOD IN STOOL
 FAILURETOTHRIVE
 DELAYED PUBERTY /AMENORRHEA
(AEC – 2000)

8. ALLERGY LEAST COMMON
OBSTRUCTIVE SYMPTOMS
 PYLORIC STENOSIS
 INTESTINAL OBSTRUCTION (PROXIMAL)
(AEC – 1000)

9. LEAST COMMON
 ASCITES – EXUDATIVE/EOSINOPHILIC
 LEAKAGE OF FLUID (STERILE)
 ENTIRE GIWALL INVOLVED
(AEC – 8000)

10.  CBC - E >2000 (AEC)
 LOW IRON/ALBUMIN
 STOOL R/M
 IgE HIGH
 SKIN PRICKTEST

12. BIOPSY
 6 Bx FROM N/AbnAREA (PATCHY)
 > 20E/hpf
R/OVASCULITIS

14. FULLTHICKNESS Bx
 IN OBSTRUCTIVE MASS LESION
 MIMICKING MALIGNANCY

15.  PARASITE INFECTION
 CELIAC DISEASE
 VASCULITIS
 IBD
 GERD
 MASTEOCYTOSIS
 HES
 NEOPLASM

16. ELIMINATION DIET
 MILK
 WHEAT(GLUTEN)
 SOY
 EGG/BEEF
ELEMENTAL DIET (VARIABLE EFFECT)

17. STEROIDS
 PREDNISOLONE - 40 mg, 2-4Wk
 FLUTICASONE - 220mu puff/ bd
 BUDESONIDE
CROMOLYN - 200 mg qid
KETOTIFEN
MONTILUKAST

18.  AVOIDED (PERSISTENT OBSTRUCTION)
 RECURRENCES

19.  MORTALITY – RARE
 MORBIDITY – MALNUTRITION
OBSTRUCTION
PERFORATION
WAXING ANDWANING COURSE
RISK OF CANCER IS NOT INCREASED