EoE Module 8 References-Change et al Clin Gastroenterol Hepatol 2023 Development of a Practical Guide to Implement and Monitor Diet Therapy for Eosinophilic Esophagitis

Change et al Clin Gastroenterol Hepatol 2023 Development of a Practical Guide to Implement and Monitor Diet Therapy for Eosinophilic Esophagitis

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Eosinophilic Esophagitis (EoE) is a chronic inflammatory disease triggered by food allergens, affecting both children and adults. It results in esophageal dysfunction and requires careful dietary management alongside potential medication. Despite the efficacy demonstrated in multiple studies, dietary therapy remains underutilized due to the complexity involved in implementation. The review, conducted by a consortium of experts from various U.S. medical institutions, aims to offer a guide on starting and sustaining dietary therapy for EoE.<br /><br />Diet therapy involves eliminating specific common food allergens from the diet to induce remission and isolate triggers. This method effectively controls symptoms without medication, although it requires strict diet adherence and endoscopic monitoring to identify food triggers accurately. First-line treatments for EoE include both dietary therapies and medications like proton pump inhibitors and topical corticosteroids. However, medications may present side effects and high costs, whereas diet therapy, particularly elimination diets, emerges as a cost-effective non-pharmacologic alternative.<br /><br />Implemented in phases, the dietary approach begins with the elimination of known food triggers for 6-8 weeks. Upon achieving remission, foods are reintroduced one at a time to pinpoint triggers through endoscopic verification. Providers must ensure patient adherence and manage any dietary challenges to maintain long-term disease control. With the absence of standardized guidelines, the consortium underscores the necessity of customized dietary plans for each patient, often best managed with the support of a dietitian. Overall, dietary therapy offers a promising alternative for EoE management, accommodating patient preferences for non-medication routes while effectively maintaining disease remission and improving quality of life.

Keywords

Eosinophilic Esophagitis

chronic inflammatory disease

food allergens

dietary management

diet therapy

elimination diets

esophageal dysfunction

proton pump inhibitors

topical corticosteroids

endoscopic monitoring