A case is presented of Churg-Strauss syndrome in a young man in whom t
he definitive diagnostic procedure was a full thickness sigmoidoscopic
rectal biopsy, with submucosal sampling. Gastrointestinal changes in
Churg-Strauss syndrome, a rare systemic illness characterised by asthm
a, blood and tissue eosinophilia, vasculitis, and granulomatous inflam
mation are common but poorly reported. The endoscopic and histopatholo
gical features of a case are described and emphasise the potential val
ue of a limited sigmoidoscopy in establishing the diagnosis, when lowe
r gastrointestinal symptoms are present.