Eosinophilic colitis: an update on pathophysiology and treatment.
BACKGROUND
Primary eosinophilic gastrointestinal disorders, a spectrum of inflammatory conditions, occurs when eosinophils selectively infiltrate the gut in the absence of known causes for such tissue eosinophilia. These may be classified into eosinophilic esophagitis, eosinophilic gastroenteritis and eosinophilic colitis (EC). This review focuses on EC: its pathogenesis, epidemiology, clinical presentation, diagnosis and current approach to treatment.


METHODS
A literature review published in English was performed using Pubmed, Ovid, Google scholar search engines with the following keywords: eosinophilic gastrointestinal disorder, EC, eosinophils, colitis and gastrointestinal.


RESULTS
The basis for primary EC appears related to increased sensitivity to allergens, principally as a food allergy in infants and a T lymphocyte-mediated event in adults. Endoscopic changes are generally modest, featuring edema and patchy granularity.


RESULTS
Clear clinical and pathological diagnostic criteria of EC and its management strategy.


CONCLUSIONS
Intestinal involvement of EC is primarily mucosal, presenting as a mild self-limited proctitis in infants and self-limited colitis in young adults. Therapeutic approaches based on case reports tend to use either elimination diets to avoid a presumed allergen; agents traditionally used in inflammatory disease or targeted drugs like anti-histamines or leukotriene receptor antagonists.


CONCLUSIONS
Prospective randomized controlled trials addressing the disease natural history, possible preventive methods and effective medical approach and long-term prognosis are required.
Division of Gastroenterology, Faculty of Medicine, University of Calgary, Teaching Research & Wellness Building, Room 6D48, 3280 Hospital Dr NW, Calgary, AB, Canada T2N4N1.
Abdulrahman A
AA
Alfadda
Martin A
MA
Storr
Eldon A
EA
Shaffer
D003092:Colitis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D003937:Diagnosis, Differential; D004802:Eosinophilia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D005512:Food Hypersensitivity / Q000150:complications; D006801:Humans; D007223:Infant; D011379:Prognosis