Eosinophilic colitis: clinical review and 2020 update

Area of Science:

• Gastroenterology
• Immunology
• Pathology

Background:

• Eosinophilic colitis (EC) is a rare inflammatory condition within the spectrum of eosinophilic gastrointestinal disorders (EGIDs).
• Diagnosis requires identifying primary eosinophilic infiltration in the colon wall of symptomatic patients.
• The etiology of primary EC is unknown, but secondary causes like allergens, infections, and drugs must be excluded.

Purpose of the Study:

• To review current literature and evaluate modern clinical strategies for the diagnosis and management of eosinophilic colitis.
• To address the challenges posed by the lack of codified diagnostic criteria and treatment guidelines for EC.

Main Methods:

• Literature review of current research on eosinophilic colitis.
• Analysis of diagnostic approaches including imaging, laboratory tests, and endoscopy.
• Evaluation of existing treatment options based on case reports and series.

Main Results:

• Eosinophilic colitis diagnosis is challenging due to undefined eosinophil thresholds and its nature as a diagnosis of exclusion.
• Current evidence for treatment efficacy is limited, primarily derived from case reports and small case series.
• Various conditions must be ruled out to confirm primary eosinophilic colitis.

Conclusions:

• There is a critical need for standardized diagnostic criteria and evidence-based treatment guidelines for eosinophilic colitis.
• A comprehensive clinical strategy integrating modern diagnostic tools and evaluating treatment outcomes is essential.
• Further research is required to improve the management of this rare EGID.