Skip to main content


Log in

Clinical characteristics of Japanese patients with eosinophilic esophagitis and eosinophilic gastroenteritis

  • Original Article—Alimentary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript



The clinical characteristics of Japanese patients with eosinophilic esophagitis (EoE) and eosinophilic gastroenteritis (EGE) have not been fully clarified. For understanding the pathogenesis as well as providing support for accurate diagnosis, precise information regarding clinical characteristics of these diseases is important.


A questionnaire-based survey of EoE and EGE was conducted in 1,078 teaching hospitals. Clinical data of patients with confirmed EoE or EGE diagnosed from 2004 to 2009 were collected.


Clinical data from 26 patients with EoE and 144 patients with EGE were collected. The mean ages of patients in both groups were in the 40s. Those with EoE frequently complained of dysphagia and heartburn, and had characteristic endoscopic features such as longitudinal furrows and multiple concentric rings in the esophagus, while only 34 % had peripheral eosinophilia. Patients with EGE frequently complained of abdominal pain and diarrhea, and approximately 80 % of them have peripheral eosinophilia. They did not have characteristic endoscopic features helpful for diagnosis. Computed tomography (CT) findings and the presence of peripheral eosinophilia were diagnostic for EGE. EGE patients with a small intestinal involvement showed the highest peripheral eosinophil counts. Glucocorticoid administration was the most widely used treatment for these diseases and its effect was favorable for at least induction of remission.


EGE is more prevalent than EoE in Japan. Patients with EGE have abdominal pain and diarrhea, high peripheral eosinophil counts, and gastrointestinal wall thickening identifiable by CT findings, while EoE is characterized by dysphagia and characteristic endoscopic features.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others


  1. Straumann A. Idiopathic eosinophilic gastrointestinal diseases in adults. Best Pract Res Clin Gastroenterol. 2008;22:481–96.

    Article  PubMed  CAS  Google Scholar 

  2. Spergel JM, Book WM, Mays E, et al. Variation in prevalence, diagnostic criteria, and initial management options for eosinophilic gastrointestinal diseases in the United States. J Pediatr Gastroenterol Nutr. 2011;52:300–6.

    Article  PubMed  Google Scholar 

  3. Yan BM, Shaffer EA. Primary eosinophilic disorders of the gastrointestinal tract. Gut. 2009;58:721–32.

    Article  PubMed  CAS  Google Scholar 

  4. Prussin C, Lee J, Foster B. Eosinophilic gastrointestinal disease and peanut allergy are alternatively associated with IL-5+ and IL-5(−) T(H)2 responses. J Allergy Clin Immunol. 2009;124:1326–32.

    Article  PubMed  CAS  Google Scholar 

  5. Rothenberg ME. Biology and treatment of eosinophilic esophagitis. Gastroenterology. 2009;137:1238–49.

    Article  PubMed  CAS  Google Scholar 

  6. Dellon ES, Peery AF, Shaheen NJ, et al. Inverse association of esophageal eosinophilia with Helicobacter pylori based on analysis of a US pathology database. Gastroenterology. 2011;141:1586–92.

    Article  PubMed  Google Scholar 

  7. Dellon ES, Gibbs WB, Fritchie KJ, et al. Clinical, endoscopic, and histologic findings distinguish eosinophilic esophagitis from gastroesophageal reflux disease. Clin Gastroenterol Hepatol. 2009;7:1305–13.

    Article  PubMed  Google Scholar 

  8. Liacouras CA, Spergel JM, Ruchelli E, et al. Eosinophilic esophagitis: a 10-year experience in 381 children. Clin Gastroenterol Hepatol. 2005;3:1198–206.

    Article  PubMed  Google Scholar 

  9. Prasad GA, Alexander JA, Schleck CD, et al. Epidemiology of eosinophilic esophagitis over three decades in Olmsted County. Minnesota. Clin Gastroenterol Hepatol. 2009;7:1055–61.

    Article  Google Scholar 

  10. Furuta GT, Liacouras CA, Collins MH, et al. Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment. Gastroenterology. 2007;133:1342–63.

    Article  PubMed  CAS  Google Scholar 

  11. Liacouras CA, Furuta GT, Hirano I, et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011;128:3–20.

    Article  PubMed  Google Scholar 

  12. Fujishiro H, Amano Y, Kushiyama Y, et al. Eosinophilic esophagitis investigated by upper gastrointestinal endoscopy in Japanese patients. J Gastroenterol. 2011;46:1142–4.

    Article  PubMed  Google Scholar 

  13. Talley NJ, Shorter RG, Phillips SF, et al. Eosinophilic gastroenteritis: a clinicopathological study of patients with disease of the mucosa, muscle layer, and subserosal tissues. Gut. 1990;31:54–8.

    Article  PubMed  CAS  Google Scholar 

  14. Sperry SL, Crockett SD, Miller CB, et al. Esophageal foreign-body impactions: epidemiology, time trends, and the impact of the increasing prevalence of eosinophilic esophagitis. Gastrointest Endosc. 2011;74:985–91.

    Article  PubMed  Google Scholar 

  15. Desai TK, Stecevic V, Chang CH, et al. Association of eosinophilic inflammation with esophageal food impaction in adults. Gastrointest Endosc. 2005;61:795–801.

    Article  PubMed  Google Scholar 

  16. Méndez-Sánchez N, Chávez-Tapia NC, Vazquez-Elizondo G, et al. Eosinophilic gastroenteritis: a review. Dig Dis Sci. 2007;52:2904–11.

    Article  PubMed  Google Scholar 

  17. Veerappan GR, Perry JL, Duncan TJ, et al. Prevalence of eosinophilic esophagitis in an adult population undergoing upper endoscopy: a prospective study. Clin Gastroenterol Hepatol. 2009;7:420–6.

    Article  PubMed  Google Scholar 

  18. Müller S, Pühl S, Vieth M, et al. Analysis of symptoms and endoscopic findings in 117 patients with histological diagnoses of eosinophilic esophagitis. Endoscopy. 2007;39:339–44.

    Article  PubMed  Google Scholar 

  19. Abe Y, Iijima K, Ohara S, et al. A Japanese case series of 12 patients with esophageal eosinophilia. J Gastroenterol. 2011;46:25–30.

    Article  PubMed  Google Scholar 

  20. Furuta K, Adachi K, Kowari K, et al. A Japanese case of eosinophilic esophagitis. J Gastroenterol. 2006;41:706–10.

    Article  PubMed  Google Scholar 

  21. Straumann A, Spichtin HP, Bernoulli R, et al. Idiopathic eosinophilic esophagitis: a frequently overlooked disease with typical clinical aspects and discrete endoscopic findings. Schweiz Med Wochenschr. 1994;124:1419–29.

    PubMed  CAS  Google Scholar 

  22. Straumann A. Eosinophilic esophagitis; a rapidly emerging disease. Esophagus. 2008;5:177–83.

    Article  Google Scholar 

  23. Straumann A, Conus S, Degen L, et al. Long-term budesonide maintenance treatment is partially effective for patients with eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2011;9:400–9.

    Article  PubMed  CAS  Google Scholar 

  24. Fox VL, Nurko S, Teitelbaum JE, et al. High-resolution EUS in children with eosinophilic “allergic” esophagitis. Gastrointest Endosc. 2003;57:30–6.

    Article  PubMed  Google Scholar 

  25. Collins MH, Blanchard C, Abonia JP, et al. Clinical, pathologic, and molecular characterization of familial eosinophilic esophagitis compared with sporadic cases. Clin Gastroenterol Hepatol. 2008;6:621–9.

    Article  PubMed  Google Scholar 

  26. Dellon ES, Gibbs WB, Rubinas TC, et al. Esophageal dilation in eosinophilic esophagitis: safety and predictors of clinical response and complications. Gastrointest Endosc. 2010;71:706–12.

    Article  PubMed  Google Scholar 

  27. Sgouros SN, Bergele C, Mantides A. Eosinophilic esophagitis in adults: what is the clinical significance? Endoscopy. 2006;38:515–20.

    Article  PubMed  CAS  Google Scholar 

  28. García-Compeán D, González González JA, Marrufo García CA, et al. Prevalence of eosinophilic esophagitis in patients with refractory gastroesophageal reflux disease symptoms: a prospective study. Dig Liver Dis. 2011;43:204–8.

    Article  PubMed  Google Scholar 

  29. Zhang L, Duan L, Ding S, et al. Eosinophilic gastroenteritis: clinical manifestations and morphological characteristics, a retrospective study of 42 patients. Scand J Gastroenterol. 2011;46:1074–80.

    Article  PubMed  Google Scholar 

  30. Khan S. Eosinophilic gastroenteritis. Best Pract Res Clin Gastroenterol. 2005;19:177–98.

    Article  PubMed  Google Scholar 

  31. Rothenberg ME, Mishra A, Brandt EB, et al. Gastrointestinal eosinophils. Immunol Rev. 2001;179:139–55.

    Article  PubMed  CAS  Google Scholar 

  32. Savarino E, Gemignani L, Zentilin P, et al. Achalasia with dense eosinophilic infiltrate responds to steroid therapy. Clin Gastroenterol Hepatol. 2011;9:1104–6.

    Article  PubMed  Google Scholar 

  33. Aceves SS, Chen D, Newbury RO, et al. Mast cells infiltrate the esophageal smooth muscle in patients with eosinophilic esophagitis, express TGF-β1, and increase esophageal smooth muscle contraction. J Allergy Clin Immunol. 2010;126:1198–204.

    Article  PubMed  CAS  Google Scholar 

  34. Korsapati H, Babaei A, Bhargava V, et al. Dysfunction of the longitudinal muscles of the oesophagus in eosinophilic oesophagitis. Gut. 2009;58:1056–62.

    Article  PubMed  CAS  Google Scholar 

  35. Kwiatek MA, Hirano I, Kahrilas PJ, et al. Mechanical properties of the esophagus in eosinophilic esophagitis. Gastroenterology. 2011;140:82–90.

    Article  PubMed  Google Scholar 

  36. Oh HE, Chetty R. Eosinophilic gastroenteritis: a review. J Gastroenterol. 2008;43:741–50.

    Article  PubMed  Google Scholar 

  37. Miller SM, Goldstein JL, Gerson LB. Cost-effectiveness model of endoscopic biopsy for eosinophilic esophagitis in patients with refractory GERD. Am J Gastroenterol. 2011;106:1439–45.

    Article  PubMed  Google Scholar 

  38. de Chambrun GP, Gonzalez F, Canva JY, et al. Natural history of eosinophilic gastroenteritis. Clin Gastroenterol Hepatol. 2011;9:950–6.

    Article  Google Scholar 

Download references


The authors thank the Japanese gastroenterologists who sent clinical and laboratory data of their patients with EoE and EGE. This study was supported by a grant from the Ministry of Health, Labour, and Welfare of Japan.

Conflict of interest

We have no COI with any commercial groups concerning the manuscript. We, the authors of this manuscript, indicate that we have no financial relationship to any commercial groups. We also state that we have full control of all primary data and that we agree to allow the journal to review our data if requested.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Yoshikazu Kinoshita.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 20 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kinoshita, Y., Furuta, K., Ishimaura, N. et al. Clinical characteristics of Japanese patients with eosinophilic esophagitis and eosinophilic gastroenteritis. J Gastroenterol 48, 333–339 (2013).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: