@article{6189772d0ff24a3d926f42ce84c8ece9,
title = "A Single-Food Milk Elimination Diet Is Effective for Treatment of Eosinophilic Esophagitis in Children",
abstract = "Background & Aims: Cow's milk protein (CMP) is the most common trigger of inflammation in children and adults with eosinophilic esophagitis (EoE). We sought to assess the clinical, endoscopic, and histologic efficacy of dietary elimination of all CMP-containing foods in EoE. Methods: We performed a prospective observational study in children with EoE treated with the 1-food elimination diet (1FED), excluding all CMP. Children and their caretakers were educated by a registered dietitian regarding dietary elimination of all CMP-containing foods, with substitutions to meet nutritional needs for optimal growth and development, and daily meal planning. Upper endoscopy with biopsies was performed after 8 to 12 weeks of treatment. The primary end point was histologic remission, defined as fewer than 15 eosinophils per high-power field. Secondary end points were symptomatic, endoscopic, and quality-of-life (QOL) improvements. Results: Forty-one children (76% male; ages, 9 ± 4 years; 88% white) underwent 1FED education and post-treatment endoscopy with biopsies. Histologic remission occurred in 21 (51%) children, with a decrease in peak eosinophils per high-power field from a median of 50 (interquartile range, 35–70) to a median of 1 (interquartile range, 0–6; P < .0001). Endoscopic abnormalities improved in 24 (59%) patients, while symptoms improved in 25 (61%). Improved symptoms included chest pain, dysphagia, and pocketing/spitting out food. Parents perceived worse QOL, while children perceived improved QOL with the 1FED. Conclusions: One-food elimination of CMP-containing foods from the diet induced histologic remission in more than 50% of children with EoE and led to significant improvement in symptoms and endoscopic abnormalities. The ease of implementation and adherence supports the 1FED as first-line dietary treatment.",
keywords = "Antigen, Children, Dairy, Dietary, EoE, Response, Treatment",
author = "Wechsler, {Joshua B.} and Sally Schwartz and Arva, {Nicoleta C.} and Kim, {Kwang Youn A.} and Liqi Chen and Melanie Makhija and Katie Amsden and Kaitlin Keeley and Saeed Mohammed and Dellon, {Evan S.} and Kagalwalla, {Amir F.}",
note = "Funding Information: Funding This work was supported primarily by the Buckeye Foundation, United States (A.F.K.). Additional support was provided by K08DK097721 (J.B.W.), institutional funds from the Ann and Robert H. Lurie Children{\textquoteright}s Hospital of Chicago, and the Consortium of Eosinophilic Gastrointestinal Researchers. Joshua B. Wechsler is a Consortium of Eosinophilic Gastrointestinal Researchers scholar trainee. The Consortium of Eosinophilic Gastrointestinal Researchers (U54 AI117804) (J.B.W.) is part of the Rare Disease Clinical Research Network, an initiative of the Office of Rare Diseases Research, National Center for Advancing Translational Research, and is funded through collaboration between the National Institute of Allergy and Infectious Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, and National Center for Advancing Translational Research. The Consortium of Eosinophilic Gastrointestinal Researchers also is supported by patient advocacy groups including the American Partnership for Eosinophilic Diseases, Campaign Urging Research for Eosinophilic Diseases, and the Eosinophil Family Coalition. Funding Information: Funding This work was supported primarily by the Buckeye Foundation, United States (A.F.K.). Additional support was provided by K08DK097721 (J.B.W.), institutional funds from the Ann and Robert H. Lurie Children's Hospital of Chicago, and the Consortium of Eosinophilic Gastrointestinal Researchers. Joshua B. Wechsler is a Consortium of Eosinophilic Gastrointestinal Researchers scholar trainee. The Consortium of Eosinophilic Gastrointestinal Researchers (U54 AI117804) (J.B.W.) is part of the Rare Disease Clinical Research Network, an initiative of the Office of Rare Diseases Research, National Center for Advancing Translational Research, and is funded through collaboration between the National Institute of Allergy and Infectious Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, and National Center for Advancing Translational Research. The Consortium of Eosinophilic Gastrointestinal Researchers also is supported by patient advocacy groups including the American Partnership for Eosinophilic Diseases, Campaign Urging Research for Eosinophilic Diseases, and the Eosinophil Family Coalition. Publisher Copyright: {\textcopyright} 2022 AGA Institute",
year = "2022",
month = aug,
doi = "10.1016/j.cgh.2021.03.049",
language = "English (US)",
volume = "20",
pages = "1748--1756.e11",
journal = "Clinical Gastroenterology and Hepatology",
issn = "1542-3565",
publisher = "W.B. Saunders Ltd",
number = "8",
}