Update on dietary therapy for eosinophilic esophagitis in children and adults

@article{MolinaInfante2017UpdateOD,
  title={Update on dietary therapy for eosinophilic esophagitis in children and adults},
  author={J. Molina-Infante and P. L. Gonz{\'a}lez-Cordero and {\'A}. Arias and A. Lucendo},
  journal={Expert Review of Gastroenterology \& Hepatology},
  year={2017},
  volume={11},
  pages={115 - 123}
}
ABSTRACT Introduction: Eosinophilic esophagitis (EoE) is a chronic inflammatory esophageal disease triggered predominantly, but not excusively, by food antigens. Elimination diet thus remains the only therapy targeting the cause of the disease. Importantly, EoE is a unique form of non-IgE mediated food allergy, largely dependant upon delayed, cell-mediated hypersensitivity. Areas covered: A comprehensive review of literature to summarize and update the most relevant advances on dietary therapy… Expand
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TLDR
This review provides evidence-based insights into the dietary management of EoE and empiric elimination of common food allergens is now recognized as the best alternative for dietary treatment, with moderate-to-high efficiency and reproducible results. Expand
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TLDR
The nutritional status of children with EoE was mildly affected and not worsened by the 2-month dietary therapy, and Evaluation after 1 year of progressive reintroduction of eliminated foods was available in 33 children. Expand
Which Patients with Eosinophilic Esophagitis (EoE) Should Receive Elemental Diets Versus Other Therapies?
TLDR
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A four-food group elimination diet (FFGED) (dairy products, wheat, egg, and legumes) for adult patients with EoE was effective in almost a third of FFGED nonresponders, resulting in a combined efficacy of 72% of both strategies. Expand
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TLDR
Dietary elimination is a successful treatment modality for adults with EoE and further research should emphasize which factors can predict effective dietary therapy. Expand
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TLDR
SFED treatment was associated with clinical and histologic improvement in EE in an observational study and should be considered as an option in the initial management of children with EE. Expand
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TLDR
All 3 dietary therapies are effective; however, an elemental diet is superior at inducing histologic remission compared with 6-food elimination and skin test-directed diets. Expand
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TLDR
An elimination diet based on SPT/APT results leads to resolution of esophageal eosinophilia in a similar proportion of patients as empiric removal of foods but required that fewer foods be removed. Expand
Identification of Specific Foods Responsible for Inflammation in Children With Eosinophilic Esophagitis Successfully Treated With Empiric Elimination Diet
TLDR
Serial single-food reintroductions following induction of histological remission with the SFED can lead to the identification of specific causal food antigen(s) in EoE. Expand
Elimination diet effectively treats eosinophilic esophagitis in adults; food reintroduction identifies causative factors.
TLDR
An elimination diet significantly improves symptoms and reduces endoscopic and histopathologic features of EoE in adults, indicating a role for food allergens in its pathogenesis. Expand
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