Practical approach to implementing dietary therapy in adults with eosinophilic esophagitis: The Chicago experience

B. Doerfler, P. Bryce, Ikuo Hirano, Nirmala Prabu Gonsalves*

*Corresponding author for this work

Research output: Contribution to journalReview article

35 Scopus citations

Abstract

Eosinophilic esophagitis (EoE) is a chronic immune/antigen-mediated esophageal disease characterized by esophageal dysfunction and esophageal mucosal eosinophilia. Diet therapy is effective in the treatment of EoE in both children and adults. The role of food allergens is well established in the pathogenesis and treatment of eosinophilic esophagitis. Empiric elimination with a six-food elimination diet (avoiding milk, wheat, egg, soy, peanuts/tree nuts, and fish/shellfish) demonstrates remission in over 70% of adults with this disease. Dietary therapy in adult EoE is becoming more accepted by both patients and clinicians. Dietary therapy can be effectively implemented in clinical practice with appropriate dietary education, patient resources, and close communication with physician and clinical staff. The ability to identify specific food triggers to help tailor dietary therapy for long-term management allows for a return to consumption of most table foods. Furthermore, the diet approach avoids the need for chronic topical corticosteroid use and possible long-term side effects of these medications. The decision to proceed with dietary therapy should be decided by patient preference and available resources. A collaborative and multidisciplinary approach including gastroenterologists, allergists, nurses, and dietitians is essential in the success of this approach.

Original languageEnglish (US)
Pages (from-to)42-58
Number of pages17
JournalDiseases of the Esophagus
Volume28
Issue number1
DOIs
StatePublished - Jan 1 2015

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Keywords

  • Dietary therapy
  • Dysphagia
  • Eosinophilic esophagitis
  • Nutrition assessment

ASJC Scopus subject areas

  • Gastroenterology

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