Food elimination diet identifies causes of difficulty swallowing and swelling of the throat

An elimination diet that identifies specific food triggers is an effective therapeutic alternative to corticosteroids for adults with EoE. Furthermore, the results of a reintroduction process in which these trigger foods are added back into a patient's diet support the fact that food antigens are driving this response; this provides new insight into the nature of the inflammatory response in adult EoE.

"By first eliminating, then systematically reintroducing foods in our adult patients, we were able to identify the specific food triggers that caused their symptoms, such as heartburn, chest pain and difficulty swallowing, or the sensation of food being stuck in their throat," said Nirmala Gonsalves, MD, of Northwestern University and the lead author of this study. "Given the poor sensitivity of skin prick testing and lack of history of food allergy or intolerance, the six-food elimination diet with reintroduction is the only reliable method to date to identify food triggers in adult eosinophilic esophagitis and should allow us to better tailor diet to individual patients for long-term management."

View a video abstract in which Dr. Gonsalves discusses her study findings:

This video is not supported by your browser at this time.

A diet that eliminates all of the six most commonly allergenic foods (milk, soy, egg, wheat, peanuts/tree nuts and shellfish/fish) significantly improves symptoms and reduces esophageal tissue damage associated with EoE in adults. In fact, 78 percent of patients achieved greater than a 50 percent reduction in peak eosinophil (white blood cell) counts in their esophagus; dysphagia symptom scores improved significantly after the elimination diet. Once trigger foods were reintroduced, all patients had recurrence of their symptoms within five days. These results suggest that EoE is likely the same disease in children and adults.

Journal reference: Gastroenterology

Provided by American Gastroenterological Association