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Eosinophilic Colitis—Child

Authors:
  • byMichael Jubinville, MPH
Publication Type:

Condition

Eosinophilic Colitis—Child

Definition

Eosinophilic colitis (EC) is the buildup of white blood cells called eosinophils. They gather in the lining of the colon. EC causes long term swelling.

There are two types of EC:

  • Primary—EC that happens on its own
  • Secondary—EC that happens because of another health issue

EC in infants often goes away on its own with time. An adolescent with EC may go back and forth between times of not having symptoms and then having severe symptoms.

Causes

Eosinophils are part of the immune system. They should only respond to an infection or injury. These cells release a chemical that causes swelling. With EC, the swelling starts or stays even though it is not needed. Over time this can lead to tissue damage, ulcers, and polyps in the colon.

It is not clear what causes EC. It is likely a blend of gene changes and the environment. It may also be linked to an allergic reaction.

Risk Factors

EC is more common in males. Other things that may raise a child’s chances of EC include:

  • Some genetic problems
  • Family members with EC or allergies
  • Food allergies
  • Having health issues such as other eosinophilic gastrointestinal diseases

Symptoms

Symptoms vary and may be more severe in some people.

Common symptoms include:

  • Severe belly pain
  • Diarrhea, with or without blood
  • Nausea
  • Vomiting
  • Fatigue
  • Problems feeding in infants

EC may lead to other problems such as:

  • Malnutrition
  • Weight loss
  • Anemia or iron deficiency from blood loss

Diagnosis

The doctor will ask about symptoms and health history. A physical exam will be done. EC can be hard to diagnose. Some tests may be able to rule out other health issues that have similar symptoms.

Tests to rule out other health issues may include:

  • Blood tests
  • Allergy tests
  • Stool tests
  • Barium enema—a type of x-ray that uses contrast material to help see the colon
  • Colonoscopy—a lighted tube with a camera is used to view the lining of the colon

A biopsy is the only way to confirm EC. A sample of the colon will be removed to look for eosinophils. This will be done through a colonoscopy.

Colonoscopy.

Copyright © 2002 Nucleus Communications, Inc. All rights reserved.

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Treatment

EC in infants often goes away on its own. Taking cow’s milk and soy from an infant's diet may help until EC is gone.

For others, the goal of treatment is to manage swelling. This will stop or slow damage to the lining of the colon. Any underlying causes found will also need to be treated.

Treatment options may include:

Prevention

There are no steps to prevent EC because the cause is unknown.

Diet Changes

Foods that cause symptoms will need to be avoided. Proteins, such as soy, nuts, eggs, or milk are common allergens. A dietitian can help families learn about a child's dietary needs.

Other changes may include:

  • Some children may have severe protein limits. Special liquid formulas may be needed to provide safer forms of protein. A feeding tube may be used for some kids.
  • A nutrition plan may be needed to help a child keep growing. This may include vitamins and supplements.

Diet Changes

Foods that cause symptoms will need to be avoided. Proteins, such as soy, nuts, eggs, or milk are common allergens. A dietitian can help families learn about a child's dietary needs.

Other changes may include:

  • Some children may have severe protein limits. Special liquid formulas may be needed to provide safer forms of protein. A feeding tube may be used for some kids.
  • A nutrition plan may be needed to help a child keep growing. This may include vitamins and supplements.

Medicine

Medicines are used to manage EC and treat the problems it causes. These may include:

  • Steroids—to reduce swelling during symptom flare ups. May be given as pills or passed into the colon.
  • Medicine to boost, change, or suppress the immune system.
RESOURCES:

CANADIAN RESOURCES:

CANADIAN RESOURCES:

References

  • Alfadda, A.A., Storr, M.A., et al. Eosinophilic colitis: epidemiology, clinical features, and current management. Therap Adv Gastroenterol, 2011; 4 (5): 301-309.
  • Eosinophilic colitis. American Partnership for Eosinophilic Disorders website. Available at: http://apfed.org/about-ead/egids/ec.
  • Non-immunoglobulin E (IgE) and mixed IgE-mediated food-related allergic disorders. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/non-immunoglobulin-e-ige-and-mixed-ige-mediated-food-related-allergic-disorders-20.
  • Uppal, V., Kreiger, P., et al. Eosinophilic gastroenteritis and colitis: a comprehensive review. Clin Rev Allergy Immunol, 2016; 50 (2): 175-188.

Contributors

  • Chelsea Skucek, MSN, BS, RNC-NIC
Last Updated:
2022-08-01

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.