Non-esophageal eosinophilic gastrointestinal disease and chronic abdominal pain in children: A multicenter experience.

Abstract

Background: Eosinophilic gastrointestinal (GI) disease (EGID) beyond eosinophilic esophagitis is not commonly reported in the developing world.

Aim: To estimate the prevalence of EGID in a selected group of pediatric patients suffering from non-functional chronic abdominal pain (CAP).

Methods: A retrospective analysis was conducted on case records of children with CAP. Those exhibiting clinical or laboratory alarming features underwent endoscopic evaluation. Histopathology reports from upper GI endoscopy and ileo-colonoscopy determined the diagnosis of EGID. Subsequent analyses included clinical presentations, presence of atopy in the children or family, hemoglobin, albumin, serum immunoglobulin E (IgE), fecal calprotectin levels, endoscopic appearances, treatment methods, and outcomes.

Results: A total of 368 children with organic CAP were subjected to endoscopic evaluation. Among them, 19 (5.2%) patients with CAP were diagnosed with EGID. The median age of the children was 11.1 years (interquartile range = 8.4-14.4). The estimated prevalence of EGID in children with organic CAP was 520/10000 children over 5 years. Periumbilical pain was the most common site (63%). Family history of atopy, peripheral blood eosinophilia, and elevated serum IgE were the three parameters significantly associated with EGID. Clinical remission was obtained in all children at 6 months. The 47% had microscopic remission and maintained remission until a 1-year follow-up. The 53% had a fluctuating clinical course after 6 months.

Conclusion: EGID beyond the esophagus is not an uncommon entity among the children of India. It can contribute significantly to the etiology of pediatric CAP.