Dietary treatment of eosinophilic gastrointestinal disorders in children

Carolina Gutiérrez-Junquera, Noam Zevit*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of reviewTo provide an overview of recent developments on dietary treatment of eosinophilic gastrointestinal disorders (EGID) in children.Recent findingsFood antigens are the main triggers of eosinophilic esophagitis (EoE); however, currently available allergy tests cannot reliably identify eliciting antigens. Studies evaluating the six-food empiric elimination diet (6FED-milk, wheat/gluten, egg, soy/legumes, nuts and fish/seafood) have shown histological remission rates of 72%. Milk, egg, wheat/gluten, and, to a lesser extent, soy/legumes were the most frequent food triggers with only one or two culprit foods identified for most patients. A 4-food elimination strategy afforded a 64% remission rate. A step-up two-four-six food elimination diet generated a 43% remission rate at the two-food elimination stage, and similar reported rates for 4FED and 6FED. Endoscopic procedures were reduced by a 20% compared with 6FED. In a prospective study including 63 children, exclusive milk elimination has been effective in 44% of them. Controlled elimination and reintroduction with histological assessment is necessary.SummaryDietary therapy of EoE has evolved from more restrictive to less restrictive diets to provide better balance between efficacy vs. nutritional deficiencies and quality of life. Data on efficacy of dietary therapy in other EGIDs are very scarce.

Original languageEnglish
Pages (from-to)210-216
Number of pages7
JournalCurrent Opinion in Clinical Nutrition and Metabolic Care
Volume23
Issue number3
DOIs
StatePublished - 1 May 2020

Funding

FundersFunder number
Dr Falk Pharma ltd

    Keywords

    • dietary therapy
    • eosinophilic esophagitis
    • eosinophilic gastritis
    • eosinophilic gastroenteritis
    • food antigen
    • nutrition

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