Management Strategies for Eosinophilic Gastritis
Non‑Steroid First‑Line Options
- For patients who wish to avoid corticosteroids, a regimen combining a twice‑daily proton‑pump inhibitor, dietary modification, and the antihistamine loratadine achieved clinical resolution in approximately 62 % of cases, supporting its use as an initial non‑steroid therapy. 1
- Implementation of elimination diets should be performed with dietitian support, as recommended by extrapolation from eosinophilic esophagitis guidelines. 1
Escalation to Corticosteroid Therapy
- In moderate disease or when the non‑steroid regimen fails after 8–12 weeks, escalation to systemic corticosteroids is advised. 2
- For severe disease or after failure of conservative therapy, prednisolone should be initiated; clinical response should be monitored and the dose tapered as tolerated. 2
Monitoring and Follow‑Up
- Endoscopic evaluation with gastric biopsies is required to document histologic response because symptom improvement does not reliably correlate with mucosal inflammation. [1][2]