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

My Life with a Diva Esophagus

Pdf Summary

This presentation by Bethany Doerfler, MS, RDN, focuses on integrating diet therapy into the treatment of Eosinophilic Esophagitis (EoE), a chronic allergic/immune condition of the esophagus triggered by food antigens. Key topics covered include the history of diet therapy in EoE, nutrition assessment, dietary treatment levels, and practical management strategies.<br /><br />Diet therapy in EoE primarily involves elimination diets aimed at removing food triggers to achieve histologic remission (reduction of eosinophils in esophageal tissue) and symptom improvement. The six-food elimination diet (6FED), removing dairy, wheat/gluten, eggs, soy/legumes, nuts, and fish/shellfish, shows about 68% efficacy. More restrictive elemental diets can have up to 94% efficacy but are less practical. Other empiric elimination options include four-food (FFED), two-food (TFED), and single-food diets, with varying success rates.<br /><br />Nutrition assessment is essential to identify weight loss, symptom impact (e.g., dysphagia, nausea), and potential nutritional deficiencies. A Registered Dietitian Nutritionist (RDN) plays a dual role in both educating patients and managing their diet plans. Shared decision-making is emphasized to balance the level of dietary restriction with patient feasibility, considering lifestyle, social situations, and anxiety related to diet adherence.<br /><br />Practical tips include identifying hidden sources of allergens (e.g., dairy in breading, soy in sauces), maintaining nutritional balance with hypoallergenic foods, and providing snack ideas and strategies for dining out safely. Adherence challenges are notable, with about 57% adherence to maintenance therapy post-6FED.<br /><br />If diet therapy is ineffective, possible causes include dietary contamination, new allergens, or the need for medical therapy optimization. There is also awareness of Avoidant Restrictive Food Intake Disorder (ARFID), which may complicate management.<br /><br />Overall, the presentation advocates multidisciplinary management involving gastroenterologists, allergists, and dietitians, supported by resources and education modules to optimize diet-based treatment of EoE, ultimately improving patient outcomes and quality of life.

Keywords

Eosinophilic Esophagitis

Diet Therapy

Elimination Diets

Six-Food Elimination Diet

Nutrition Assessment

Registered Dietitian Nutritionist

Symptom Management

Food Allergens

Adherence Challenges

Multidisciplinary Management