NUTRITIONAL TREATMENT OF EOSINOPHILIC GASTROENTERITIS

Abstract

Eosinophilic gastroenteritis (EGE) is a digestive system disease characterized by inflammation of the eosinophils predominantly in the stomach and small intestine. Being rare and difficult to diagnose and treat causes EGE to be evaluated as a very complex disease. The mainstay of treatment is to reduce eosinophilic infiltration and prevent gastrointestinal symptoms that can cause serious complications in the long term. Present treatments include diet, pharmacological and surgical treatment. Although the etiology of EGE is uncertain, it is thought to be caused by food sensitivity, especially food allergens, by increasing the Th2 type cellular response in the gastrointestinal tract of patients. It is debated that overweight and vitamin D deficiency may be a risk factor for EGE. All of these generate processes that increase pro-inflammatory cytokines and decrease anti-inflammatory cytokines, thus causing a Th2-type cellular response. Also, it is thought that lowered immune system tolerance and diseases such as asthma/ allergies may also support the development of EGE. Especially; in the last publications, dietary approaches are frequently emphasized in the treatment of the EGE. The main purpose of dietary approaches; to reduce the symptoms of the patient by removing the nutrients that increase the severity of the disease from the diet and preventing the patient from being exposed to allergens. Diets applied; elemental diet, empirical elimination diet, allergy testing directed elimination diet. Even though pharmacological treatment is the main treatment patients generally respond well to steroids. However, long term use of steroids can cause serious side effects. Therefore, recently the use of different agents and combined treatments are recommended. Surgical treatment is considered at the last stage. In addition to this, recurrence is seen in most of the operated patients. EGE, which diagnosis and treatment are quite complex, has an increasing incidence today. This study, it is aimed to present the treatment methods of EGE, its relationship with nutrition, and the importance of diet treatment. In addition, different dietary approaches used in the treatment of the disease were classified and case series were evaluated in the light of the current literature.