Elimination Diet - Effective in Treating Adults with Eosinophilic Esophagitis, Study


Elimination diet is an effective way of treating eosinophilic esophagitis (EoE), according to a new study by the University of North Carolina.

"By eliminating specific foods from patients' diets, symptoms improved in 71 percent of patients, and endoscopic appearance improved in 54 percent," said researchers from the School of Medicine in a press release. "These strong results support dietary elimination therapy as an effective treatment for adults suffering from EoE."

Dietary elimination therapy is a popular modality in pediatric patients suffering from EoE - an allergen/immune mediated condition. This is the first study to discover the employment of dietary elimination in adults.

Currently, esophageal inflammation is treated using corticosteroids. However, FDA has not approved even one corticosteroid. Researchers said that not all patients respond to the pills and when the medication is stopped, EoE almost always recurs. Hence, there is a growing need for a new treatment for patients suffering from EoE.

For the study, the researchers conducted a retrospective cohort study using the school's EoE database from 2006-2012. The participants diagnosed with EoE were aged 18 years or older.

The study examined two diet elimination plans. In the first plan or targeted elimination, foods that had a positive reaction and identified by patient self-report as being possible triggers were eliminated through skin prick testing. In the second plan, the six-food elimination diet - dairy, wheat, eggs, soy, nuts and seafood - were discarded from the participant's diet regardless of the test results.

The researchers found that 68 percent of participants who were part of the targeted elimination diet plan reported symptom improvement as compared to 78 percent of those who followed the six-food elimination diet plan.

Researchers added one food (or food group) every six weeks in participants who experienced improved symptoms in response to the six-food elimination diet. Eggs and dairy were found to be the most common triggers, affecting 44 percent of patients.

The participants included in the study have failed steroid therapy and represent susceptible EoE patients. However, the elimination diet plan can also be applied to patients resistant to steroids.

The finding is published in the Clinical Gastroenterology and Hepatology.

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