Eosinophilic esophagitis diet symptoms diagnosis treatment causes, elimination diet

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07/18/23

Eosinophilic esophagitis (EoE) is a chronic, immune/antigen-mediated esophageal disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation.
The pathogenesis of EoE is the result of an interplay between genetic, environmental, and host immune system factors.
The three main modes of treatment for EoE are dietary therapy, pharmacologic therapy, dilatation of esophageal strictures, and combinations of these interventions as clinically indicated.
The primary choices for initial dietary avoidance of potential food allergen triggers in patients with EoE are:
•Empiric elimination diet – Empirically eliminate foods to which patients are most likely to be allergic.
•Testing-directed elimination diet – Perform skin prick testing (SPT) and atopy patch testing (APT) for food allergies, with subsequent elimination of foods with positive test results (plus cow's milk because of its poor negative predictive value on testing).
•Elemental diet – Place the patient on an amino acid-based (elemental) formula with exclusion of all solid foods, which eliminates all potential food allergens.