Constipation--another manifestation of eosinophilic gastroenteritis

Eosinophilic gastroenteris (EG) is a unique disease in which eosinophils penetrate into the layers of the GI tract. It is classified by the depth of the eosinophilic penetration, that can either be mucosal, muscularis or serosal. Symptoms vary with the bowel site involved as well as the depth of the eosinophilic penetration. Symptoms of the mucosal form of EG usually include nausea, vomiting, diarrhea and abdominal pain while constipation is extremely rare. We present a case of mucosal EG presenting as constipation and abdominal pain in a 43 year old female. Constipation is not a typical symptom associated with EG and while muscularis EG can cause decreased colonic motility and obstruction, constipation with mucosal EG has not been previously reported. We are presenting the first case report of constipation associated with mucosal EG. Thus EG should be considered in the differential diagnosis of patients presenting with constipation and abdominal pain and can easily be diagnosed with mucosal biopsies and treated with steroid therapy.