Eosinophilic gastroenteritis (EG) is a rare and heterogeneous disorder characterized by gastrointestinal (GI) symptoms and eosinophilic infiltration of the GI tract. Symptoms are dependent upon site of the GI tract involved and depth of involvement. The diagnostic criteria include: (i) the presence of GI symptoms, (ii) histopathology demonstrating predominant eosinophilic infiltration, (iii) the absence of other conditions that cause eosinophilia, and (iv) no eosinophilic involvement of organs outside the GI tract. Diagnosis requires a clinical history, physical exam, and documentation of any history of atopic disorders, allergies, and drug allergies. Laboratory evaluation includes a complete blood count with differential to evaluate for peripheral eosinophilia. Endoscopic evaluation with random biopsies remains the cornerstone for diagnosis. Histopathologic diagnosis typically requires an infiltration level of 20 or more eosinophils per high power field. Management strategies are based upon severity of symptoms and include antidiarrheals, dietary adjustments, and steroid therapy.
Practical Gastroenterology and Hepatology: Esophagus and Stomach p. 292-396