UEG: Dietary treatments for inducing remission of eosinophilic esophagitis
as presented at the annual meeting of United European Gastroenterology
Eosinophilic esophagitis (EoE) is a chronic esophageal immune/allergy-mediated disorder that represents a distinctive form of food allergy, according to Spanish researchers presenting at UEG, held in October in Vienna.
Various dietary interventions have been used to treat patients with EoE, yielding varied results. Researchers at the Hospital General de Tomelloso, Spain, performed a systematic search in MEDLINE, EMBASE, and SCOPUS for studies investigating the efficacy of various dietary interventions in inducing remission (<15 eosinophils/hpf) of inflammatory infiltration as observed in esophageal biopsies from both pediatric and adult EoE patients.
The researchers calculated summary estimates for exclusive feeding with amino acid-based elemental formulas, allergy testing-directed food elimination diets, and six-food elimination diets (SFED). The search yielded 578 references, of which 30 were included in the quantitative summary. All told, the studies described 1285 EoE patients (1124 children and 161 adults) undergoing different dietary treatments. According to the researchers, elemental diets were effective in 90.4% of cases, SFED in 73%, and allergy testing-directed food elimination induced remission in 46.3% of cases. Additional dietary therapy strategies (elimination of cow’s milk [68.2%] and gluten-free diets [52.2%]) were also evaluated. Overall, no significant differences in remission rates were documented between children and adults (67.4% vs 71.5%).
"Dietary treatment is effective in achieving histological remission in patients with EoE," the researchers concluded. "Elemental diets and SFEDs were the most consistent alternatives, achieving <15 eosinophils/hpf in 90.4% and 73% of treated patients, respectively."
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