Eosinophilic Disorders of the Gastrointestinal Tract

Eosinophilic disorders of the gastrointestinal tract are defined as diseases that are associated with eosinophil-rich inflammatory reactions selectively affecting the gastrointestinal tract.  Eosinophil is a type of an immune cell that is normally involved in clearing parasitic infections.  However, it is also associated with various allergic diseases, which are becoming increasingly common in our society, and include asthma, eczema, and rhinoconjunctivitis.  Primary eosinophilic disorders of the gastrointestinal tract include eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis, and eosinophilic colitis.  In addition, a number of other systemic diseases may be associated with secondary eosinophilic inflammatory reactions in the gastrointestinal tract.

Eosinophilic esophagitis is the most common eosinophilic disorder of the gastrointestinal tract.  This disease is increasingly recognized by physicians and properly diagnosed.  However, it is also increasing dramatically in real prevalence.  This rise parallels the general increase in the prevalence of autoimmune and allergic diseases in the industrialized world, but may be one of its most dramatic examples.  Several decades ago this disease was merely a curiosity in the case report literature.  Now it is more prevalent than inflammatory bowel disease in the pediatric population, and a dramatic rise is also seen in the adults. 

Typical symptoms of eosinophilic esophagitis include difficulty swallowing, nausea and vomiting, abdominal pain.  The disease may be associated with other allergic conditions, such as asthma or eczema.  Treatment usually involves topical steroids, which are swallowed to coat the esophagus, and are not absorbed into the body.  However, some patients require additional treatments.  Most patients can be helped dramatically following the diagnosis.

Research is being conducted in our division into the basic mechanisms of eosinophilic esophagitis by Dr. Alex Khoruts.  His program also includes a clinical focus in the eosinophilic disorders of the gastrointestinal tract.