Eosinophilic colitis: an update on pathophysiology and treatment.

Area of Science:

• Gastroenterology
• Immunology

Background:

• Eosinophilic gastrointestinal disorders (EGIDs) are inflammatory conditions characterized by eosinophil infiltration of the gastrointestinal tract without other known causes.
• Eosinophilic colitis (EC) is a specific type of EGID, alongside eosinophilic esophagitis and gastroenteritis.

Purpose of the Study:

• This review focuses on the pathogenesis, epidemiology, clinical presentation, diagnosis, and current treatment strategies for eosinophilic colitis (EC).

Main Methods:

• A comprehensive literature review was conducted using PubMed, Ovid, and Google Scholar.
• Keywords included "eosinophilic gastrointestinal disorder," "EC," "eosinophils," "colitis," and "gastrointestinal."

Main Results:

• Primary EC pathogenesis involves heightened sensitivity to allergens, particularly food allergies in infants and T-lymphocyte-mediated events in adults.
• Endoscopic findings in EC are typically mild, showing edema and patchy granularity.

Conclusions:

• Intestinal EC primarily affects the mucosa, presenting as mild, self-limiting proctitis in infants and colitis in young adults.
• Current therapeutic approaches include elimination diets, traditional anti-inflammatory agents, and targeted drugs like antihistamines or leukotriene receptor antagonists.
• Prospective randomized controlled trials are essential to investigate EC's natural history, prevention, effective treatments, and long-term prognosis.