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Eosinophilic Gastroenteritis Medication

  • Author: MyNgoc T Nguyen, MD; Chief Editor: Julian Katz, MD  more...
 
Updated: Dec 29, 2015
 

Medication Summary

Oral glucocorticosteroids with anti-inflammatory properties are the primary therapy, especially for patients with obstructive symptoms and eosinophilic ascites. Most patients with eosinophilic gastroenteritis respond dramatically to oral glucocorticosteroids within 2 months. Successful treatment with other anti-inflammatory medications, such as leukotriene modifiers (eg, montelukast) and mast cell stabilizers (eg, cromolyn), has been reported.

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Corticosteroids

Class Summary

Have anti-inflammatory properties and cause profound and varied metabolic effects. Corticosteroids modify the body's immune response to diverse stimuli.

Fluticasone inhaled (Flovent)

 

Decreases recruitment of inflammatory cells including eosinophils and decreases the release of eotaxins and other inflammatory mediators. Dosage required is higher than dosage used in asthma.

Budesonide (Pulmicort Respule) oral viscous suspension

 

Decreases inflammation, reduces capillary permeability.

Prednisolone (AK-Pred, Delta-Cortef)

 

Decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reducing capillary permeability. Equivalent dosages of prednisone or methylprednisolone may be used.

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Mast cell stabilizers

Class Summary

Inhibit degranulation of sensitized mast cells following exposure to allergens.

Cromolyn (Intal, Gastrocrom)

 

Inhibits release of histamine, leukotrienes, and other mediators from sensitized mast cells. It also inhibits the influx of neutrophils, as well as the formation of the active form of NADPH oxidase which in turn prevents tissue damage caused by oxygen radicals.

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Leukotriene receptor antagonists

Class Summary

Prevent or reverse some of the pathologic features associated with the inflammatory process mediated by leukotrienes C4, D4, and E4. Successful treatment of eosinophilic gastroenteritis has been reported.

Montelukast (Singulair)

 

Potent and selective antagonist of leukotriene D4 (LTD4) at the cysteinyl leukotriene receptor, CysLT1.

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Contributor Information and Disclosures
Author

MyNgoc T Nguyen, MD Clinical Associate Professor, Department of Pediatrics, University of California, San Francisco, School of Medicine

MyNgoc T Nguyen, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology

Disclosure: Nothing to disclose.

Coauthor(s)

Jean-Luc Szpakowski, MD 

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Julian Katz, MD Clinical Professor of Medicine, Drexel University College of Medicine

Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law, Medicine & Ethics, American Trauma Society, Association of American Medical Colleges, Physicians for Social Responsibility

Disclosure: Nothing to disclose.

Additional Contributors

Ronnie Fass, MD, FACP, FACG Chief of Gastroenterology, Head of Neuroenteric Clinical Research Group, Southern Arizona Veterans Affairs Health Care System; Professor of Medicine, Division of Gastroenterology, University of Arizona School of Medicine

Ronnie Fass, MD, FACP, FACG is a member of the following medical societies: American College of Gastroenterology, American College of Physicians-American Society of Internal Medicine, American Gastroenterological Association, American Neurogastroenterology and Motility Society, American Society for Gastrointestinal Endoscopy, Israeli Medical Association

Disclosure: Received grant/research funds from Takeda Pharmaceuticals for conducting research; Received consulting fee from Takeda Pharmaceuticals for consulting; Received honoraria from Takeda Pharmaceuticals for speaking and teaching; Received consulting fee from Vecta for consulting; Received consulting fee from XenoPort for consulting; Received honoraria from Eisai for speaking and teaching; Received grant/research funds from Wyeth Pharmaceuticals for conducting research; Received grant/research funds f.

Acknowledgements

Simmy Bank, MD Chair, Professor, Department of Internal Medicine, Division of Gastroenterology, Long Island Jewish Hospital, Albert Einstein College of Medicine

Disclosure: Nothing to disclose.

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Biopsy specimen of eosinophilic gastroenteritis.
Biopsy specimen of eosinophilic gastroenteritis.
Biopsy specimen of eosinophilic gastroenteritis.
 
 
 
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