EoE Module 8 References-Arias et al Gastroenterology 2014 Efficacy of dietary interventions in patients with EoE Systematic review and metaanalysis

Arias et al Gastroenterology 2014 Efficacy of dietary interventions in patients with EoE Systematic review and metaanalysis

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The article discusses a systematic review and meta-analysis of dietary interventions for inducing histologic remission in patients with eosinophilic esophagitis (EoE), a chronic immune-mediated inflammatory disorder characterized by symptoms such as esophageal dysfunction. The study reviewed the effectiveness of various dietary treatments, namely elemental diets, allergy test-directed food elimination diets, and 6-food elimination diets (SFED), in achieving disease remission. <br /><br />Researchers systematically searched major databases, identifying 33 relevant studies involving 1,317 patients (1,128 children and 189 adults). Elemental diets were found to be highly effective, achieving histologic remission in 90.8% of cases. SFEDs demonstrated a 72.1% efficacy, while allergy testing–directed elimination diets were less effective, with a remission rate of 45.5%. The study revealed that results from SFEDs showed the greatest homogeneity, suggesting they may be the most reliably effective dietary treatment. In contrast, allergy testing-directed diet results were highly variable and less consistent.<br /><br />The research emphasizes the potential of dietary modifications as a first-line treatment for EoE, providing a drug-free alternative to corticosteroids. Elemental diets and SFEDs were most effective, although elemental diets come with drawbacks such as poor taste and high cost, limiting their use mostly to children. The authors suggest that better allergy testing methods might improve the effectiveness of directed elimination diets. Overall, this study supports the role of dietary therapy in managing EoE, particularly advocating for SFEDs due to their high efficacy and applicability to both children and adults. Further research is recommended to explore long-term outcomes and refine dietary management strategies.

Keywords

eosinophilic esophagitis

dietary interventions

histologic remission

elemental diets

6-food elimination diets

allergy test-directed diets

systematic review

meta-analysis

dietary therapy

esophageal dysfunction