Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Sep 9, 2025; 14(3): 101468
Published online Sep 9, 2025. doi: 10.5409/wjcp.v14.i3.101468
Non-esophageal eosinophilic gastrointestinal disease and chronic abdominal pain in children: A multicenter experience
Bhaswati C Acharyya, Meghdeep Mukhopadhyay, Hema Chakrabarty
Bhaswati C Acharyya, Meghdeep Mukhopadhyay, Department of Pediatric Gastroenterology and Hepatology, Institute of Child Health, Kolkata 700017, West Bengal, India
Bhaswati C Acharyya, Department of Paediatric Gastroenterology and Hepatology, Manipal Hospital, Kolkata 700099, West Bengal, India
Hema Chakrabarty, Department of Histopathology, Manipal Hospitals, Kolkata 700029, West Bengal, India
Author contributions: Acharyya BC planned the study, collected the data, and prepared the manuscript; Mukhopadhyay M collected the data and wrote the manuscript; Chakrabarty H contributed to the H/P diagnosis and corrected the pathology portion of the text; All authors read and approved the final version of the manuscript to be published.
Institutional review board statement: Ethical approval was obtained from the Institute of Child Health and AMRI Hospital Ethics Committee.
Informed consent statement: This was a retrospective case note analysis, so verbal consent was obtained in retrospect from patients with eosinophilic gastrointestinal disease (parents after ethical approval from the two institutions).
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: There is no restriction on data sharing.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bhaswati C Acharyya, MD, Professor, Department of Pediatric Gastroenterology and Hepatology, Institute of Child Health, 11 Dr Biresh Guha Street, Kolkata 700017, West Bengal, India. bacharyya21@gmail.com
Received: September 15, 2024
Revised: February 9, 2025
Accepted: March 4, 2025
Published online: September 9, 2025
Processing time: 274 Days and 1.8 Hours
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.

Keywords: Children; Chronic abdominal pain; Chronic; Eosinophilic gastrointestinal disease; Eosinophilic esophagitis; Allergy web; Endoscopy; Non-esophageal

Core Tip: Eosinophilic gastrointestinal disease (EGID) is often an underdiagnosed cause of chronic abdominal pain (CAP) in children. This study estimated how frequently EGID is responsible for the significant pain some of these children experience. This study is unique because although abdominal pain is the most common symptom of EGID, its prevalence in CAP cases has rarely been explored. Additionally, this study uncovered key features of EGID, such as clinical and endoscopic findings, fecal calprotectin levels, presence or absence of atopy, serum immunoglobulin E levels, and response to treatment. These findings contribute valuable insights to the growing knowledge of EGID in children.