title: Eosinophilic colitis is a sporadic self-limited disease of middle-aged people: a population-based study.
abstract: OBJECTIVE
  Eosinophilic colitis (EC) is a rare manifestation of eosinophilic gastrointestinal disorders. Due to its rarity, little information is available on its natural history.
  
  
  METHODS
  From the single population-based pathology database of the Calgary Health Region (comprising a population of 1.28 million in 2008), cases of EC during the period 1996-2008 were identified. Medical records of all adults diagnosed with EC were identified and the pathology reviewed. The patients were then contacted for follow-up using a standardized questionnaire.
  
  
  RESULTS
  Seven cases of EC (four in women) were identified, with a median follow-up of 45 (23-79) months. The median age at diagnosis was 42 (22-70) years. Symptoms at diagnosis were abdominal pain (86%), nonbloody diarrhoea (57%), bloody diarrhoea (29%) and significant (>10%) weight loss (29%). Three patients gave a history of allergic reactions to drugs and four reported allergy to cows' milk. Endoscopic findings were nonspecific, ranging from oedema to small aphthous ulceration. An eosinophilic infiltrate was identified in the lamina propria in the initial colonic biopsy in all patients. Over the longer term, three patients experienced spontaneous resolution without treatment. Two continued to have mild diarrhoea and abdominal cramps but did not require medical therapy. Two patients required medical treatment by 5-aminosalicylic acid, with one requiring prednisone and azathioprine maintenance therapy.
  
  
  CONCLUSIONS
  Eosinophilic colitis is a rare mostly self-limiting disease affecting middle-aged adults. It usually has a mild clinical course and drug treatment is not usually necessary. When required, drug treatment follows the standard medication for other inflammatory bowel disease.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of Calgary, Alberta, Canada.
authors.forename: A A
authors.initials: AA
authors.lastname: Alfadda
authors.forename: E A
authors.initials: EA
authors.lastname: Shaffer
authors.forename: S J
authors.initials: SJ
authors.lastname: Urbanski
authors.forename: M A
authors.initials: MA
authors.lastname: Storr
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D015331:Cohort Studies; D003092:Colitis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003106:Colon / Q000473:pathology*; D003113:Colonoscopy; D003967:Diarrhea / Q000209:etiology; D018450:Disease Progression; D004802:Eosinophilia / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D008875:Middle Aged; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D015431:Weight Loss; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine
keywords: Eosinophilic gastrointestinal disorder; colitis; eosinophilic colitis; eosinophilic proctocolitis; eosinophils; gastrointestinal