Treatment of eosinophilic esophagitis with diets: an update.

Treatment of eosinophilic esophagitis with diets: an update. Minerva Gastroenterol Dietol. 2019 Nov 20;: Authors: Lucendo AJ, Molina-Infante J Abstract Eosinophilic esophagitis (EoE) is a chronic inflammatory esophageal disease triggered and maintained predominantly by food antigens. It represents a unique form of non-IgE mediated food allergy, largely dependent upon delayed, cell-mediated hypersensitivity. First-line therapies for EoE consist on drugs with anti-inflammatory effect (mainly including topic steroids and proton pump inhibitors) and dietary therapy. An elimination diet that avoids the consumption of food triggers currently remains the only therapy targeting the cause of EoE. Currently, available food allergy tests are suboptimal to predict food triggers for EoE, especially in adult patients. Elemental diets consisting in exclusively feeding patients with amino acid-based formulas and empiric 6-food elimination diets (withdrawing milk, wheat, egg, soy, nuts, and fish/seafood for 6 weeks) have consistently shown the best efficacy rates. However, their high level of restriction and the need for multiple endoscopies have hampered their implementation in clinical practice. In contrast, studies on 6-food elimination diets have been instrumental to decipher the most common food triggers in patients with EoE, being milk, wheat/gluten, and egg involved in most of patients from the United States, Spain, and Australia. Hence less r...
Source: Minerva Gastroenterologica e Dietologica - Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research