Abdominal Pain Relieved By A Warm Hot Water Bottle: An Atypical Presentation Of Eosinophilic Gastroenteritis

A 26-year-old woman presented with a 3-month history of worsening episodic abdominal pain, which was associated with frequent passage of watery stools, nausea and dyspepsia. Her peripheral eosinophil count was markedly elevated. This responded well to a reducing regimen of corticosteroids. Her symptoms completely resolved with a corresponding fall in eosinophil count. The patient was diagnosed with eosinophilic gastroenteritis. We have not considered steroid-sparing agents at this point, but should she have future exacerbations then this will be considered. LEARNING POINTS: Keep eosinophilic gastroenteritis in mind when reviewing patients with atypical gastrointestinal symptoms and elevated peripheral eosinophil counts, particularly in patients with a history of atopy. The clinical history, histology and cross-sectional imaging is complementary in securing a diagnosis. Follow-up imaging and endoscopic evaluation can be useful in monitoring response to treatment.