Advanced Practice Provider EoE Program (Live/Virtual) | October 2025-Swallowing Struggles: My Life with a Diva Esophagus

Video Transcription

Video Summary

Bethany Durfler, a registered dietitian specializing in digestive disorders and eosinophilic esophagitis (EoE), discussed integrating diet therapy into EoE treatment. She emphasized the role of medical nutrition therapy, involving thorough nutrition assessments to understand patients' baseline diets, allergen exposure, lifestyle, and symptom impact. Key clinical concerns include significant weight loss and nutrition-impacting symptoms like swallowing difficulties. Historically, elemental diets were effective but highly restrictive, leading to the development of empiric elimination diets targeting common allergens—initially the six-food elimination diet (SFED), later simplified to four-food or single-food elimination (often dairy).<br /><br />Durfler highlighted shared decision-making, balancing diet efficacy with patient quality of life and the need for repeated endoscopies to monitor treatment success. The SOFEED trial showed that while the six-food diet had slightly better histologic remission, single-food elimination improved symptoms comparably with less burden. Most patients react to one or two foods, so starting with less restrictive diets is common, escalating if needed. Adherence depends on factors like social situations and anxiety.<br /><br />She underscored the need for dietitian involvement to tailor diets, prevent nutritional deficiencies, and address potential contamination and behavioral issues such as avoidant restrictive food intake disorder (ARFID). Comprehensive patient education, behavioral support, and practical resources are critical for effective diet therapy in EoE.

Asset Subtitle

Bethany Doerfler, MS, RD, LDN

Keywords

eosinophilic esophagitis

diet therapy

medical nutrition therapy

elimination diets

six-food elimination diet

patient adherence

avoidant restrictive food intake disorder