EoE Module 8 References-Doerfler et al Gastroenterol Hepatol N Y 2023 Dietary Management of Eosinophilic Esophagitis

Doerfler et al Gastroenterol Hepatol N Y 2023 Dietary Management of Eosinophilic Esophagitis

Pdf Summary

The article "Dietary Management of Eosinophilic Esophagitis" explores approaches to managing eosinophilic esophagitis (EoE), a chronic immune-mediated disorder characterized by esophageal dysfunction. The condition is triggered by food antigens and impacts both children and adults. Dietary management involving various food elimination strategies has been proven effective in reducing symptoms and inflammation.<br /><br />EoE's dietary therapies range from elemental diets to more gradual elimination diets. Elemental diets have high efficacy but face challenges such as poor palatability, high cost, and nutritional deficiencies due to their restrictive nature. The six-food elimination diet (SFED) is the best-studied alternative, with a reported 70% success rate, improved adherence, and fewer dietary limitations. The SFED eliminates common allergens including milk, wheat, soy, eggs, nuts, and fish.<br /><br />Recent studies have compared varying levels of elimination diets, like the two-food or four-food elimination diets, suggesting they are also effective and may reduce the need for frequent endoscopies. The choice between these diets involves shared decision-making with patients, considering factors such as nutritional status, lifestyle, and personal preferences.<br /><br />Nutritional management is crucial, requiring dietary assessments to avoid deficiencies. Micronutrient supplementation and diet diversification are essential, particularly when eliminating commonly nutritious foods. Registered dietitians play an important role in evaluating and guiding individuals undertaking dietary therapy.<br /><br />Additionally, for patients who do not fully respond to dietary changes, alternative treatments like proton pump inhibitors (PPIs) or stepped-up dietary restrictions may be considered. Monitoring and assessing treatment efficacy often require repeated endoscopies, though newer, less invasive tests are emerging. Ultimately, dietary management of EoE emphasizes patient education, careful monitoring, dietary adherence, and a personalized approach to therapy.

Keywords

Eosinophilic Esophagitis

dietary management

food elimination

elemental diets

six-food elimination diet

nutritional deficiencies

shared decision-making

registered dietitians

proton pump inhibitors

patient education