Lam Angela Y, Gonsalves Nirmala
Department of Gastroenterology and Hepatology, Kaiser Permanente San Francisco, San Francisco, California.
Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Gastroenterol Hepatol (N Y). 2025 Aug;21(8):511-519.
For eosinophilic esophagitis (EoE), the most well researched of the eosinophilic gastrointestinal diseases (EGIDs), there is a plethora of knowledge for its diagnosis and management; however, much less guidance is available for the non-EoE EGIDs. Efforts have been made to characterize the clinical features, epidemiology, diagnosis, and natural history of EGIDs, as the frequency of the non-EoE EGIDs has continued to rise. The diagnosis of the different non-EoE EGIDs, eosinophilic gastritis, enteritis, and colitis, can be challenging because of their rarity and heterogeneous presentations which can lead to delayed diagnosis and poor health-related quality of life in affected patients. Guidelines for histologic evaluation and diagnostic criteria for non-EoE EGID are actively being developed. Effective management of non-EoE EGIDs is possible with currently available assessments and therapies, with more treatments on the horizon, highlighting the need for improved understanding of non-EoE EGIDs. This article will review the diagnosis and management of the non-EoE EGIDs, focusing on the consensus nomenclature, nuances in diagnosis, and management options.
对于嗜酸性粒细胞性食管炎(EoE),这是研究最为充分的嗜酸性粒细胞性胃肠道疾病(EGIDs),其诊断和管理方面已有大量知识;然而,对于非EoE的EGIDs,可用的指导却少得多。随着非EoE的EGIDs发病率持续上升,人们已努力对EGIDs的临床特征、流行病学、诊断及自然史进行描述。不同的非EoE的EGIDs,即嗜酸性粒细胞性胃炎、肠炎和结肠炎,其诊断可能具有挑战性,因为它们罕见且表现多样,这可能导致诊断延迟以及受影响患者的健康相关生活质量较差。目前正在积极制定非EoE的EGID的组织学评估指南和诊断标准。利用现有的评估和治疗方法,对非EoE的EGIDs进行有效管理是可行的,未来还会有更多治疗方法出现,这凸显了加强对非EoE的EGIDs理解的必要性。本文将回顾非EoE的EGIDs的诊断和管理,重点关注共识命名法、诊断细微差别和管理选项。