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Eosinophilic Colitis

The AGA guidelines on eosinophilic gastrointestinal disorders offer evidence-based recommendations for diagnosis, management, and monitoring. Developed by experts, they cover clinical evaluation, dietary strategies, pharmacologic therapy, histologic criteria, endoscopic assessment, and pediatric considerations, ensuring comprehensive care and improved patient outcomes.

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Nghia Nguyen

About the Expert

Dr. Nghia Nguyen, DO, is a board-certified gastroenterologist providing advanced digestive care in the Greater Houston area. He earned his medical degree from the Texas College of Osteopathic Medicine and completed both his Internal Medicine residency and Gastroenterology fellowship at the University of Texas at Rio Grande Valley. Dr. Nguyen specializes in treating conditions such as acid reflux, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and liver disorders.

Common Causes and Risk Factors

  • Food allergies or sensitivities (especially in adults)
  • Family history of eosinophilic gastrointestinal conditions
  • Immune system imbalances (weak or overactive)
  • Other allergic disorders such as asthma or eczema

Signs and Symptoms

  • Abdominal pain or cramping
  • Frequent diarrhea or loose stools
  • Unexplained weight loss
  • Blood or mucus in the stool
  • Recurrent flare-ups of symptoms

How Dr. Nghia Nguyen Diagnoses Eosinophilic Colitis?

Dr. Nguyen uses a step-by-step approach:

1. Medical History and Physical Exam

He reviews your symptoms—abdominal or epigastric pain, diarrhea, weight loss—and asks about food allergies, family history of eosinophilic gut disorders, asthma or eczema. A focused abdominal exam checks for tenderness or bloating.

2. Blood Tests

Complete blood count (CBC) to measure eosinophil levels and screen for anemia or signs of systemic inflammation.

3. Stool Studies

  • Stool culture and ova & parasite exam to rule out infectious causes.
  • Fecal calprotectin or lactoferrin to quantify intestinal inflammation.

4. Endoscopy with Biopsy

Colonoscopy (or flexible sigmoidoscopy) allows direct visualization of the colon lining. Multiple tissue samples are taken to confirm eosinophil infiltration under the microscope—the definitive test for eosinophilic colitis.

5. Allergy Testing (If Indicated)

Skin‐prick or blood tests (specific IgE panels) help identify food sensitivities that may trigger eosinophil activation.

Dr. Nghia Nguyen
Treatment

Our Team offers a full range of care for eosinophilic colitis.

1. Diet and Lifestyle Changes

  • Elimination diet to identify and remove food triggers
  • Avoidance of common problem foods such as dairy, soy, or gluten
  • Gradual reintroduction of foods under expert guidance

2. Medications

  • Steroids (oral or foam) to reduce inflammation
  • Mast cell stabilizers or leukotriene blockers when needed
  • Biologic therapies for more severe or long-term cases

3. Procedures and Nutrition Support

  • Endoscopy to monitor colon inflammation and assess flare-ups
  • Feeding tube support in rare, severe cases to maintain nutrition
Dr Nghia Nguyen

About the Author

Dr. Nghia Nguyen, DO, is a board-certified gastroenterologist providing advanced digestive care in the Greater Houston area. He earned his medical degree from the Texas College of Osteopathic Medicine and completed both his Internal Medicine residency and Gastroenterology fellowship at the University of Texas at Rio Grande Valley. Dr. Nguyen specializes in treating conditions such as acid reflux, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and liver disorders.

Frequently Asked Questions

What is eosinophilic colitis?

Eosinophilic colitis is a rare inflammatory condition where a type of white blood cell called eosinophils accumulates in the colon, leading to pain, diarrhea, and other digestive symptoms.

What causes eosinophilic colitis?

It may be linked to food allergies, immune system responses, or other underlying allergic conditions. The exact cause is not always known.

What are common symptoms?

Symptoms include abdominal pain, chronic diarrhea (often with blood or mucus), weight loss, fatigue, and poor growth in children.

How is eosinophilic colitis diagnosed?

Diagnosis involves colonoscopy with biopsies, blood tests for eosinophil levels, and allergy testing to identify possible triggers.

What foods should I avoid?

Common triggers include milk, soy, eggs, wheat, and nuts. An elimination diet guided by an allergist or dietitian can help identify and avoid problem foods.

Is there a cure?

There is no known cure, but symptoms can be managed with dietary changes, medications, and follow-up care. Many patients achieve long-term symptom control.

What treatments are available?

Treatments may include corticosteroids to reduce inflammation, allergy medications, and a special elimination diet tailored to individual sensitivities.

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