Common and disparate clinical presentations and mechanisms in different eosinophilic gastrointestinal diseases

J Allergy Clin Immunol. 2024 Jun;153(6):1472-1484. doi: 10.1016/j.jaci.2024.03.013. Epub 2024 Mar 28.


Eosinophilic gastrointestinal diseases (EGIDs) are a group of diseases characterized by selective eosinophil infiltration of the gastrointestinal (GI) tract in the absence of other causes of eosinophilia. These diseases are generally driven by type 2 inflammation, often in response to food allergen exposure. Among all EGIDs, the clinical presentation often includes a history of atopic disease with a variety of GI symptoms. EGIDs are traditionally separated into eosinophilic esophagitis (EoE) and non-EoE EGIDs. EoE is relatively better understood and now associated with clinical guidelines and 2 US Food and Drug Administration-approved treatments, whereas non-EoE EGIDs are rarer and less well-understood diseases without US Food and Drug Administration-approved treatments. Non-EoE EGIDs are further subclassified by the area of the GI tract that is involved; they comprise eosinophilic gastritis, eosinophilic enteritis (including eosinophilic duodenitis), and eosinophilic colitis. As with other GI disorders, the disease presentations and mechanisms differ depending on the involved segment of the GI tract; however, the differences between EoE and non-EoE EGIDs extend beyond which GI tract segment is involved. The aim of this article is to summarize the commonalities and differences between the clinical presentations and disease mechanisms for EoE and non-EoE EGIDs.

Keywords: Eosinophilic gastrointestinal diseases; eosinophilic colitis; eosinophilic enteritis; eosinophilic esophagitis; eosinophilic gastritis.

Publication types

  • Review

MeSH terms

  • Animals
  • Enteritis* / diagnosis
  • Enteritis* / immunology
  • Enteritis* / pathology
  • Eosinophilia* / diagnosis
  • Eosinophilia* / immunology
  • Eosinophilia* / pathology
  • Eosinophilic Esophagitis* / diagnosis
  • Eosinophilic Esophagitis* / immunology
  • Eosinophilic Esophagitis* / pathology
  • Eosinophils / immunology
  • Eosinophils / pathology
  • Gastritis* / diagnosis
  • Gastritis* / immunology
  • Gastritis* / pathology
  • Gastrointestinal Diseases / diagnosis
  • Gastrointestinal Diseases / immunology
  • Humans

Supplementary concepts

  • Eosinophilic enteropathy