High Discovery Rate of Duodenal and Gastric Eosinophilia in Patients With Unexplained Moderate–Severe Abdominal Symptoms: A Prospective US Multisite Study

Eosinophilic gastritis (EoG) and eosinophilic duodenitis (EoD), are chronic inflammatory conditions characterized by GI tissue eosinophilia and persistent, often debilitating, GI symptoms. Although considered rare, emerging evidence suggests that the prevalence of eosinophilic GI diseases is increasing in the United States, and maybe more prevalent than previously thought. Notably, diagnosis requires an adequate biopsy protocol, as disease is often patchy, and the diagnosis may be overlooked if eosinophils are not counted. The aim of this prospective, multicenter study was to investigate the discovery rate of gastric and duodenal eosinophilia among patients in secondary GI care with moderate–severe unexplained abdominal symptoms. Abdominal symptoms were measured using the Total Symptom Score (TSS), a previously developed daily symptom questionnaire measuring 8 GI symptoms with a score range of 0–80.5 For comparison, and to better characterize normal levels, we performed the same assessments in a group of healthy, asymptomatic controls in a separate study.