Eosinophilic gastroenteritis: a case report and review of the literature

BackgroundEosinophilic gastroenteritis (EoG) is a rare disease of unknown etiology characterized by patchy or diffuse eosinophilic infiltration of the gastrointestinal tract wall. As clinical presentation and endoscopic/ radiological findings are nonspecific, diagnosis may only be ascertained by histologic findings.Clinical case This article presents a case of EoG with associated colonic involvement but without peripheral eosinophilia. Although no allergy could be demonstrated, the clinical symptoms and histologic pattern of diffuse eosinophilic mucosal infiltration disappeared after steroid therapy, as discovered by a careful endoscopic follow-up.Discussion Current concepts of this complex disorder and a review of the literature are presented

Chronic constipation diagnosis and treatment evaluation: The "CHRO.CO.DI.T.E." study

Background: According to Rome criteria, chronic constipation (CC) includes functional constipation (FC) and irritable bowel syndrome with constipation (IBS-C). Some patients do not meet these criteria (No Rome Constipation, NRC). The aim of the study was is to evaluate the various clinical presentation and management of FC, IBS-C and NRC in Italy. Methods: During a 2-month period, 52 Italian gastroenterologists recorded clinical data of FC, IBS-C and NRC patients, using Bristol scale, PAC-SYM and PAC-QoL questionnaires. In addition, gastroenterologists were also asked to record whether the patients were clinically assessed for CC for the first time or were in follow up. Diagnostic tests and prescribed therapies were also recorded. Results: Eight hundred seventy-eight consecutive CC patients (706 F) were enrolled (FC 62.5%, IBS-C 31.3%, NRC 6.2%). PAC-SYM and PAC-QoL scores were higher in IBS-C than in FC and NRC. 49.5% were at their first gastroenterological evaluation for CC. In 48.5% CC duration was longer than 10 years. A specialist consultation was requested in 31.6%, more frequently in IBS-C than in NRC. Digital rectal examination was performed in only 56.4%. Diagnostic tests were prescribed to 80.0%. Faecal calprotectin, thyroid tests, celiac serology, breath tests were more frequently suggested in IBS-C and anorectal manometry in FC. More than 90% had at least one treatment suggested on chronic constipation, most frequently dietary changes, macrogol and fibers. Antispasmodics and psychotherapy were more frequently prescribed in IBS-C, prucalopride and pelvic floor rehabilitation in FC. Conclusions: Patients with IBS-C reported more severe symptoms and worse quality of life than FC and NRC. Digital rectal examination was often not performed but at least one diagnostic test was prescribed to most patients. Colonoscopy and blood tests were the "first line" diagnostic tools. Macrogol was the most prescribed laxative, and prucalopride and pelvic floor rehabilitation represented a "second line" approach. Diagnostic tests and prescribed therapies increased by increasing CC severity

Eosinophilic gastroenteritis: a case report and review of the literature

BackgroundEosinophilic gastroenteritis (EoG) is a rare disease of unknown etiology characterized by patchy or diffuse eosinophilic infiltration of the gastrointestinal tract wall. As clinical presentation and endoscopic/ radiological findings are nonspecific, diagnosis may only be ascertained by histologic findings.Clinical case This article presents a case of EoG with associated colonic involvement but without peripheral eosinophilia. Although no allergy could be demonstrated, the clinical symptoms and histologic pattern of diffuse eosinophilic mucosal infiltration disappeared after steroid therapy, as discovered by a careful endoscopic follow-up.Discussion Current concepts of this complex disorder and a review of the literature are presented.</p