Dietary therapy for eosinophilic esophagitis: chances and limitations in the clinical practice.

Dietary therapy for eosinophilic esophagitis: chances and limitations in the clinical practice.
Expert Rev Gastroenterol Hepatol. 2020 Jul 02;:
Authors: Lucendo AJ, Molina-Infante J
Abstract
INTRODUCTION: Eosinophilic esophagitis (EoE) is a non-IgE-mediated food allergy that currently represents the main cause of dysphagia and food impaction in children and young adults. Diet remains the only therapy targeting the cause of the disease. Relevant advances in recent years allow novel approaches to dietary therapy in EoE.
AREAS COVERED: An up-to-date review on dietary therapy for EoE is provided, as a potential first-line anti-inflammatory therapy able to induce and maintain remission in a significant proportion of patients. Unpractical elemental diets and suboptimal food allergy testing-directed food restrictions paved the way for empiric elimination diets, which currently are to be considered as the most effective drug-free treatment for EoE. After largely restrictive empiric six-food elimination diets, most efficient step-up approaches now include four-food and two-food elimination diets. The potential of milk-elimination is also discussed.
EXPERT COMMENTARY: An empiric elimination diet step-up strategy should be currently considered as the initial approach for dietary treatment in EoE patients of all ages. Compared to a top-down strategy, step-up diets reduce the need for endoscopic procedures, shortens diagnostic pro...

Source: Expert Review of Gastroenterology and Hepatology - July 4, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research