Cow's milk elimination: A novel dietary approach to treat eosinophilic esophagitis

Amir F Kagalwalla*, Katie Amsden, Ameesh Shah, Sally Ritz, Maria Manuel-Rubio, Katherine Dunne, Suzanne P. Nelson, Barry K Wershil, Hector Melin-Aldana

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

108 Scopus citations


Objectives: Cow's-milk protein is one of the food antigens responsible for causing eosinophilic esophageal inflammation in a majority of children. We describe our experience with treating eosinophilic esophagitis (EoE) in children by eliminating only cow's milk from their diets. Methods: This retrospective study assessed the short-term clinical and histological response to eliminating cow's-milk protein from the diet of children with EoE. Only patients undergoing a subsequent upper endoscopy to assess their histological response were included in this analysis. Results: We identified 17 (12 boys and 5 girls) children with EoE who excluded only cow's milk from their diet. Remission was induced in 11 of 17 (65%) patients; within the remission group, 7 (41%) achieved complete histological remission and 4 patients (24%) were in significant histological remission. The mean peak pre- and posttreatment counts for those in remission were 76±40 and 2±4 (P<0.01), respectively. Conclusions: Elimination of cow's milk-induced clinical and histological remission in 65% (95% confidence interval 42%-88%) of children with EoE in whom it was attempted. This approach offers distinct advantages over other dietary treatment approaches for the initial management of children with EoE. The role of eliminating cow's milk alone for the treatment of EoE warrants further prospective study.

Original languageEnglish (US)
Pages (from-to)711-716
Number of pages6
JournalJournal of pediatric gastroenterology and nutrition
Issue number6
StatePublished - Dec 1 2012


  • Cow's-milk allergy
  • Elimination diet
  • Eosinophilic esophagitis
  • Food allergy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology


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