Prevalence of Eosinophilic Enteritis
The prevalence of eosinophilic enteritis is estimated at approximately 5.1 per 100,000 persons, making it a rare gastrointestinal disorder that is significantly less common than eosinophilic esophagitis. 1
Current Epidemiological Data
Overall Prevalence Estimates
The most robust population-based estimate comes from a 2017 US healthcare database study of over 35 million individuals, which identified an overall prevalence of 5.1 per 100,000 persons for eosinophilic enteritis. 1
Administrative database studies estimate the prevalence of non-esophageal eosinophilic gastrointestinal diseases (including eosinophilic enteritis) to be approximately 3-8 per 100,000, representing roughly 50,000 cases in the United States. 2
A 2011 survey-based study extrapolated an estimated prevalence of 28 per 100,000 for eosinophilic gastroenteritis or colitis combined, though this methodology is less rigorous than direct population-based studies. 3
Prevalence estimates range between 2.1 and 17.6 per 100,000 individuals depending on age, sex, and ethnicity, though these conditions may be significantly underdiagnosed. 4
Demographic Characteristics
The majority of patients with eosinophilic enteritis are women (57.7%), Caucasian (77.5%), and adults over 18 years of age (83.5%). 1
This female predominance in eosinophilic enteritis contrasts sharply with eosinophilic esophagitis, which shows a 3:1 male predominance. 5
Comparison to Eosinophilic Esophagitis
Relative Disease Burden
Eosinophilic esophagitis is substantially more common than eosinophilic enteritis, with a pooled prevalence of 34.4 cases per 100,000 population (42.2 per 100,000 in adults and 34 per 100,000 in children). 5
The prevalence of eosinophilic esophagitis has increased dramatically from mean estimates of 15 per 100,000 before 2007 to 63 per 100,000 since 2017, representing a true increase in disease incidence rather than simply improved recognition. 5
Survey-based estimates suggest eosinophilic esophagitis prevalence of approximately 52 per 100,000, nearly 10-fold higher than eosinophilic enteritis. 3
Historical data from Switzerland showed eosinophilic esophagitis prevalence increased from 2 per 100,000 to 27 per 100,000 over a 16-year period. 5
Clinical Context and Diagnostic Challenges
Underdiagnosis Concerns
Recent evidence suggests eosinophilic enteritis and other non-esophageal eosinophilic gastrointestinal diseases may be significantly underdiagnosed in clinical practice. 2
A prospective colonoscopy study found that 2.6% of 2,469 consecutive patients undergoing colonoscopy for lower abdominal symptoms had eosinophilic gastroenteritis, suggesting the condition may be more common than administrative databases indicate. 6
Only 7.8% of patients with eosinophilic gastroenteritis in this prospective study had endoscopic mucosal abnormalities, meaning the vast majority had normal-appearing mucosa on colonoscopy, contributing to underdiagnosis. 6
Disease Severity and Natural History
Eosinophilic enteritis is generally considered a benign disease, but up to 50% of patients may experience unpredictable relapses and a chronic course rather than a single self-limited episode. 1
In the prospective colonoscopy study, 9.4% of patients with eosinophilic gastroenteritis had severe disease at presentation, and 10.9% required systemic steroid treatment. 6
Important Clinical Caveats
The true prevalence of eosinophilic enteritis remains uncertain due to its nonspecific clinical presentation, frequent absence of endoscopic abnormalities, and the requirement for histopathological diagnosis with intestinal biopsies. 1, 6
Multiple segments of the gastrointestinal tract can be involved simultaneously in the same patient, and there may be overlap between different eosinophilic gastrointestinal diseases, complicating epidemiological classification. 2, 4
Geographic variation in prevalence has not been extensively studied for eosinophilic enteritis, unlike eosinophilic esophagitis where higher prevalence is documented in northeastern states and urban areas. 3