EoE Module 8 References-Visaggi et al nutrients 2021 Dietary management of EoE Tailoring the approach

Visaggi et al nutrients 2021 Dietary management of EoE Tailoring the approach

Pdf Summary

Eosinophilic esophagitis (EoE) is a chronic disease caused by food allergens, characterized by inflammation and dysfunction in the esophagus. Its prevalence has been rising, particularly in Europe and North America, affecting both children and adults. Common symptoms include dysphagia and food impaction.<br /><br />Diagnosing EoE involves endoscopy and biopsy, revealing 15 or more eosinophils per high-power field. Treatment includes dietary management, proton pump inhibitors, corticosteroids, biologics, and, if necessary, esophageal dilation. However, dietary management remains the only long-term, drug-free treatment targeting the disease's cause.<br /><br />There are multiple dietary approaches, including elemental diets, and various elimination diets like the six-food elimination diet (SFED), which excludes dairy, wheat, egg, soy, nuts, and seafood. This method is effective in achieving histological remission in about 72% of cases. Elemental diets, which use amino-acid-based formulas, can induce remission in roughly 90% of patients but are less feasible due to poor palatability and high cost.<br /><br />The elimination diet starts with eliminating common allergen foods, with subsequent reintroduction and endoscopic monitoring to identify triggers. This approach's success hinges on patient adherence and multiple endoscopies, which can impact quality of life and increase costs.<br /><br />Selecting the appropriate diet is patient-specific, taking into account dietary habits, allergies, nutritional status, and the ability to perform follow-up endoscopies. Despite drawbacks like potential nutritional deficits and reduced quality of life, dietary management allows some patients to avoid long-term medication.<br /><br />Current research focuses on optimizing dietary approaches by minimizing unnecessary restrictions and endoscopies. Overall, dietary management of EoE offers a sustainable, non-medical treatment strategy when tailored to individual patient needs.

Keywords

Eosinophilic esophagitis

food allergens

dysphagia

endoscopy

biopsy

dietary management

elimination diet

elemental diet

histological remission

patient adherence