P672 Eosinophilia of the gut: Is it inflammatory bowel disease?
S. Chetcuti Zammit*1, J. Gauci2, M. Cachia2, K. Sapiano2, P. Ellul1
1Mater Dei Hospital, Gastroenterology, Msida, Malta, 2Mater Dei Hospital, Medicine, Msida, Malta
Eosinophilic gastroenteropathy (EG) is an uncommon condition. The causes for this can be numerous, as well as non-specific. Inflammatory bowel disease (IBD) is 1 of the causes. It can also be a manifestation of atopy. The aims of our study were to determine if patients who present with eosinophilia of the gut are eventually diagnosed with IBD and to determine if patients with EG have a higher rate of atopic conditions namely, asthma, allergic rhinitis, and eczema.
Adult patients who had gastrointestinal eosinophilia were identified through the histopathology department and recruited. Their clinical case notes were reviewed. Patients were interviewed and asked questions regarding asthma, allergic rhinitis, and eczema.
In total, 66 patients (39 females; mean age 48.4 SD ± 18.5) were recruited. The mean eosinophilic count was 0.353 SD ± 1.08 (normal range 0.10 –0.70 x 10 9/L). The commoner clinical presentations were diarrhoea (42.4%), abdominal pain (33.3%), and weight loss (8.2%). The parts of the gastrointestinal tract where eosinophilic infiltration was present were stomach (6), colon (37), small bowel (SB) (7), SB and colon (12), oesophageal (1), oesophageal and colon (2), and stomach, SB, and colon (1). Further, 25.8% of patients were later diagnosed with IBD (10 patients with ulcerative colitis; 6 patients with Crohn’s disease, and 1 patient with indeterminate colitis). No other secondary causes for GE were present in the rest of the patients, and their symptoms resolved without any medical intervention. The prevalence of allergic rhinitis (41.3%) (p < 0.002) and eczema (26.1%) (p < 0.001) with GE were higher than that of the general population. Although asthma (17.4%) was more frequently present in patients with GE than the general population, this did not reach statistical significance (p < 0.62).
A high proportion of patients (25.8%) with GE was subsequently diagnosed with IBD. Occurrences of asthma, eczema, and allergic rhinitis in patients with underlying EG are higher than in the general population. Most of the patients had transient GI symptoms that later resolved. Thus, GE may represent an atopic condition of the gut or a response to a food allergen.