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Eosinophilic proctitis and treatment in adults

Sabahattin Destek, MD1, Vahit Onur Gul, MD2, Serkan Ahioglu, MD3. 1Bezmialem Foundation University School of Medicine Dragos Hospital General Surgery Department, 2Edremit State Hospital General Surgery, 3Edremit State Hospital

Goal: Eosinophilic rectitis (ER) is a rare form of primary eosinophilic gastrointestinal disease common in adolescents and newborns. ER in elder patients is generally chronic and recurrent disease. Genetic predispositions, environmental factors, allergic conditions such as food intolerance are stand out in the etiology. Symptoms such as diarrhea, rectal bleeding and increased mucus production are typical for ER. Allergic conditions such as atopic dermatitis are accompanied by these patients. Diagnosis is made by demonstrating mucosal eosinophilic inflammation in endoscopic biopsy. In this report ER should be considered in the differential diagnosis if presence of gastrointestinal symptoms associated with food in atopic and allergic patients.

Case: Fifty-six years old female patient; she was admitted to our hospital with intermittent diarrhea of 10-15 times a day in about 3 years, abdominal pain, abdominal swelling and fatigue complaints. Being allergic to dust and increase in complaints when eats fermented foods and dairy products was remarkable in her history. There was no eosinophil in her peripheral blood smear. Serum fibrinogen, anti-microsomal anti-neutrophilic cytoplasmic autoantibodies, sedimentation and CA 19-9 levels were high. Stool examination was abundant in leukocytes erythrocytes and mucus, but no evidence for parasites. Antral gastritis was found in her upper gastrointestinal endoscopy examination. In her lower gastrointestinal endoscopy examination there are polyps in her descending colon and sigmoid colon, edema and erythema in rectal mucosa. Chronic gastritis, tubular adenoma in the descending colon, hyperplastic polyp in the sigmoid colon and eosinophilic pericryptitis in the rectum is determined in her histopathological examination. Dairy products and fermented foods were eliminated from the diet of ER diagnosed patient and symptoms are revealed.

Result: ER is a rare disease characterized by eosinophilic inflammation. ER can be mixed with other gastrointestinal diseases because its symptoms are not specific to the disease. Diagnosis begins with suspected to the disease. Definitive diagnosis is made by endoscopic examination and biopsy. Drugs such as steroids can be used in the treatment together with the elimination of food. If toilet habits change in atopic patients, especially with taking of certain foods, EC should be kept in mind.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 80914

Program Number: P178

Presentation Session: Poster (Non CME)

Presentation Type: Poster

1,103

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