It’s a feeling I’ve heard described so many times in my clinic. That persistent, nagging stomach upset. Sometimes it’s pain, sometimes it’s just…off. You eat, and instead of feeling satisfied, you feel uncomfortable, maybe even nauseous. If this sounds familiar, and you’ve been wondering what on earth could be going on, one possibility, though it’s quite uncommon, is something called Eosinophilic Gastritis.
It’s a bit of a mouthful, I know. Let’s break it down.
So, What Exactly Is Eosinophilic Gastritis?
At its heart, Eosinophilic Gastritis (EG) is a condition where your stomach gets inflamed – that’s the “gastritis” part. The “eosinophilic” part refers to eosinophils. These are a specific type of white blood cell, little soldiers in your immune system. Normally, they hang out in small numbers, helping fight off certain infections and playing a role in allergic reactions.
But in EG, for reasons we’re still figuring out, too many of these eosinophils decide to gather in the lining of your stomach. And when they build up, they can cause irritation, swelling, and over time, even damage. Think of it like a party getting a bit too rowdy in a small room – things start to get a bit chaotic and uncomfortable.
EG is considered a chronic condition, meaning it’s something that sticks around for the long haul. It can pop up in anyone, at any age, though we tend to see it diagnosed most often in adults between 30 and 50. And, interestingly, it seems to affect slightly more men than women.
You might be a bit more likely to develop EG if you, or someone in your family, has a history of allergic conditions. Things like:
- Asthma
- Food intolerances or true food allergies
- Hay fever (what we doctors call allergic rhinitis)
- A persistent runny nose (rhinitis)
- Skin rashes like eczema
EG is actually one of several “eosinophilic gastrointestinal diseases,” or EGIDs. These are a group of conditions where eosinophils cause trouble in different parts of your digestive system. For instance, Eosinophilic Esophagitis (EoE) affects the esophagus (the tube from your mouth to your stomach) and is the most common EGID. There’s also Eosinophilic Colitis (EC), which involves the large intestine. It’s even possible to have high eosinophils in a few places at once.
What Might You Feel with Eosinophilic Gastritis?
The symptoms of EG can be a bit all over the place, and honestly, they can mimic a lot of other stomach troubles. That’s partly why it can sometimes take a while to get a clear diagnosis. Often, the signs are mild to moderate, but they can really impact your day-to-day life. You might experience:
- Abdominal pain – this is a big one. It can range from a dull ache to sharper pains.
- Fluid buildup in your belly (doctors call this ascites)
- Diarrhea
- Nausea and sometimes vomiting
- Feeling full quickly or having a loss of appetite
- Difficulty swallowing (we term this dysphagia)
- Heartburn that just won’t quit
- Fatigue – that deep-down tired feeling
- Unexplained weight loss, or in kids, poor growth
- Low levels of red blood cells, which is anemia
How Do We Figure Out If It’s Eosinophilic Gastritis?
Getting to a diagnosis of Eosinophilic Gastritis usually involves a few steps. Because the symptoms are so general, we first need to rule out other, more common culprits.
It usually starts with a good chat about your symptoms and your medical history. I’ll do a physical exam. Then, we’ll likely run some blood tests, including a complete blood count (CBC). This can sometimes show a higher-than-normal level of eosinophils in your blood, which is a clue. But, and this is important, you can have EG even if your blood eosinophil count is normal.
The real key to confirming EG is often an upper endoscopy. This sounds scarier than it is. We use a thin, flexible tube with a tiny camera on the end to take a look inside your esophagus, stomach, and the first part of your small intestine. We’re looking for any signs of inflammation or irritation.
During the endoscopy, we’ll also take tiny tissue samples – this is called a biopsy. These samples go to a pathologist, a doctor who specializes in looking at tissues under a microscope. They’ll count the number of eosinophils in the stomach tissue. If there are significantly more eosinophils than there should be, that points strongly towards EG. Sometimes, if the eosinophils are hiding in the deeper layers of the stomach wall, it can be a bit trickier to spot them with standard biopsies, which can delay things.
We might also suggest allergy testing. Since EG is often linked to an immune response, sometimes to food, figuring out if you have specific food allergies can be really helpful for treatment.
Managing Eosinophilic Gastritis: What Are the Options?
Okay, so if it turns out to be EG, what do we do? Well, there isn’t a “cure” right now, but the good news is we have ways to manage it and help you feel much better. The goal is to reduce the inflammation and control your symptoms.
Treatment often involves a two-pronged approach: diet and medication.
- Dietary Changes:
- Elimination Diet: This is often a first step. We might ask you to remove common food allergens (like dairy, wheat, soy, eggs, nuts, or seafood) from your diet for a period. If your symptoms improve, we then reintroduce foods one by one to see which one might be the trigger. It takes patience, I won’t lie.
- Elemental Diet: For more severe cases, or if an elimination diet is too tricky, we might suggest an elemental diet. This involves getting all your nutrition from a special liquid formula that’s broken down into its simplest forms, so it’s very unlikely to cause an allergic reaction.
- For infants, this might mean switching to a different type of baby formula. Sometimes, iron supplements are also needed if there’s anemia.
- Medications:
- Corticosteroids: Drugs like prednisone or budesonide are very effective at reducing inflammation. Budesonide often has fewer body-wide side effects as it’s designed to work more directly in the gut. We usually try to use the lowest effective dose for the shortest time needed.
- Immunosuppressants: In some cases, if steroids aren’t enough or can’t be used long-term, medications like azathioprine might be considered to help calm down the immune system’s overreaction.
It’s not an emergency situation, but getting an early diagnosis and starting treatment is important, especially for little ones, to prevent issues like malnutrition.
Looking Ahead with Eosinophilic Gastritis
Living with a chronic condition like EG can have its ups and downs. Most people, with the right management, do very well. You’ll likely need regular check-ups, and possibly repeat endoscopies with biopsies from time to time, just to see how things are going and if we need to adjust your treatment plan.
It can be a bit of an adjustment, especially the dietary changes. Planning meals, social events – it can feel overwhelming at first. But working closely with your healthcare team, which might include a dietitian or a gastroenterologist (a specialist in digestive diseases), can make a huge difference.
Take-Home Message: Understanding Your Gut
If you’re dealing with ongoing stomach issues, here’s what I’d like you to remember about Eosinophilic Gastritis:
- It’s a rare condition where specific white blood cells (eosinophils) build up in your stomach, causing inflammation.
- Symptoms can include abdominal pain, nausea, diarrhea, and difficulty eating.
- Diagnosis often involves an upper endoscopy and biopsy to count eosinophils in the stomach lining.
- While there’s no cure, Eosinophilic Gastritis is manageable with dietary changes (like elimination or elemental diets) and medications (like corticosteroids).
- It’s a chronic condition, but with proper management, you can lead a healthy, active life. Don’t hesitate to talk to us if your symptoms are persistent or worsening.
You’re not alone in this. If you’re worried about your stomach symptoms, please come and talk to us. We’re here to help figure things out and get you on the path to feeling better.