Pediatric eosinophilic colitis (EC)

What is pediatric eosinophilic colitis (EC)?

Eosinophilic colitis (EC) is a rare condition where too many eosinophils, a type of white blood cell, gather in the large intestine. Eosinophils are necessary for the body's response to allergic reactions, asthma and parasitic infections. But too many eosinophils can cause swelling and inflammation.

EC is a type of eosinophilic gastrointestinal disorder (EGID). Like other EGIDs, EC might be associated with other conditions, such as food allergies or asthma, and can affect how your child eats, grows and develops.

Risk factors

Children with a personal or family history of food allergies are at a higher risk for developing this condition. In general, EGIDs are slightly more common among boys and are most prevalent in older children and adults.

What are the signs and symptoms of pediatric eosinophilic colitis (EC)?

• Abdominal pain

• Anemia

• Bloody diarrhea

• Diarrhea

How is pediatric eosinophilic colitis (EC) diagnosed?

Our team uses a series of tests to diagnose EC in children, including:

• Allergy testing - These tests may not be indicated in all patients but in some patients can provide information about which foods might be triggering your child’s EC.

• Colonoscopy - For this test, we use a thin, flexible tube with a tiny camera attached to it, called a scope. The scope helps us examine your child’s colon, rectum and last part of the small intestine.

• Flexible sigmoidoscopy - Using a scope, your child’s care team will examine their lower colon and rectum. During a colonoscopy or flexible sigmoidoscopy, our team will collect a small portion of tissue to look for eosinophils under a microscope. Your child’s care team might order these tests throughout your child’s care, as well, to see how well treatment is working.

Your child’s physician will tell you what the next steps are for your child. Not every child needs all of these tests.

What causes pediatric eosinophilic colitis (EC)?

EC is triggered by your child’s allergies and food intolerances. For many children, the exact trigger is unknown. However, the protein found in cow’s milk is a common trigger of EC.

How is pediatric eosinophilic colitis (EC) treated?

During your child’s first visit, we will also use child-friendly language, equipment and amenities to tailor our approach to helping your child feel comfortable and at ease while we treat their EC. Our expert team of multidisciplinary specialists will develop a custom treatment plan for your child that is based on their medical history and that works best for your family.

Your child’s treatment plan will focus on:

• Eliminating possible triggers of your child’s EC - We will eliminate common trigger foods, such as milk or wheat, as well as any foods we already know your child is allergic to from their diet. In some cases, especially with infants, we will put your child on a liquid formula diet in which the allergen is completely broken down. That way, your child can get the nutrition they need while also preventing the inflammation from worsening. Removing food triggers from your child’s diet helps prevent eosinophils from causing damage to your child’s intestine.

• Resolving the inflammation in your child’s large intestine - We may introduce steroids or proton pump inhibitors to target and reduce your child’s intestinal inflammation.