Eosinophilic gastritis is a chronic stomach condition characterized by an unusual buildup of eosinophils, a specific type of white blood cell, within the stomach lining. This accumulation triggers inflammation and can lead to damage within the stomach wall. While considered rare, it can affect individuals across all age groups, though it is most frequently identified in adults.
Understanding Eosinophilic Gastritis
Eosinophils are immune cells that normally play a role in defending the body against parasites and in allergic reactions. In eosinophilic gastritis, these cells gather in large numbers in the stomach, where they are not typically abundant. When eosinophils degranulate, they release toxic proteins which can damage the surrounding stomach tissue. This sustained inflammation can disrupt normal stomach function and lead to various physical symptoms.
The exact reason for this abnormal eosinophil accumulation is often unclear, but it is largely considered to be an immune system overreaction. This immune response may be triggered by certain foods or environmental allergens. Individuals with a history of other allergic conditions, such as asthma, eczema, or food allergies, appear to have a higher susceptibility to developing eosinophilic gastritis. If left unmanaged, the persistent inflammation and damage can interfere with nutrient absorption, potentially leading to complications such as malnutrition and weight loss over time.
Recognizing the Symptoms
The symptoms of eosinophilic gastritis can vary widely among individuals and range from mild to moderate in their intensity. Common indicators often include abdominal pain, which can manifest as cramping or a dull ache in the stomach area. Many individuals also experience nausea and vomiting after eating. Digestive disturbances like diarrhea are also frequently reported, indicating broader gastrointestinal involvement. Systemic symptoms such as fatigue and unintended weight loss may develop as the body struggles with inflammation and potential nutrient malabsorption. Some patients might also develop anemia, often due to chronic blood loss that is not always visible, or from poor iron absorption.
Diagnosing Eosinophilic Gastritis
Diagnosing eosinophilic gastritis typically begins with a thorough review of a patient’s symptoms and detailed medical history. Blood tests are often performed, which may reveal an elevated count of eosinophils in the bloodstream, a condition known as eosinophilia. The most direct diagnostic step involves an upper endoscopy. During this procedure, a thin, flexible tube with a camera is inserted through the mouth to visualize the lining of the esophagus, stomach, and duodenum.
Small tissue samples, or biopsies, are taken from different areas of the stomach lining during the endoscopy. These tissue samples are then examined under a microscope by a pathologist to count the number of eosinophils present per high-power field. A diagnosis of eosinophilic gastritis is confirmed when a specific threshold of eosinophils is found within the stomach tissue. The challenge in diagnosis often arises because the symptoms can mimic those of more common gastrointestinal issues, requiring careful differentiation.
Treatment and Management
While there is no known cure for eosinophilic gastritis, various strategies are employed to manage symptoms and reduce inflammation. Medical treatments often involve the use of corticosteroids, which directly act on the inflamed stomach lining to suppress the immune response and decrease eosinophil counts. For more severe or persistent cases, systemic corticosteroids or other immunosuppressant medications may be considered to reduce widespread inflammation.
Dietary modifications are also a significant component of managing the condition. Elimination diets involve systematically removing common food allergens or suspected trigger foods from the patient’s diet to identify and avoid specific dietary triggers. Another approach is an elemental diet, which involves consuming only a specialized liquid formula containing pre-digested nutrients, allowing the digestive system to rest and inflammation to subside. Treatment plans are highly individualized, as responses to therapies can vary greatly among patients. Effective management often requires close collaboration between the patient and a team of healthcare providers, including gastroenterologists, allergists, and registered dietitians. This multidisciplinary approach helps tailor treatments to the patient’s specific symptoms and triggers, aiming to improve their quality of life.