Module 9 References-Doerfler et al Dis Esophagus 2015 Practical approach to implementing dietary theraoy in adults with EoE The Chicago experience

Doerfler et al Dis Esophagus 2015 Practical approach to implementing dietary theraoy in adults with EoE The Chicago experience

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The review article discusses dietary therapy approaches for adults with eosinophilic esophagitis (EoE), a chronic esophageal disease caused by immune/antigen responses, leading to esophageal dysfunction and inflammation. The Chicago experience highlights the effectiveness of diet therapy, particularly the Six-Food Elimination Diet (SFED), which excludes milk, wheat, egg, soy, nuts, and fish, achieving remission in over 70% of adults.<br /><br />Key points include:<br /><br />1. EoE and its link to food allergens are well-established. Elimination of specific foods can induce remission, reducing the need for chronic corticosteroid therapy, which has potential long-term side effects.<br /><br />2. The SFED approach, developed to overcome the impracticalities of elemental diets and the limitations of allergy tests, involves a 6-week exclusion of common allergens followed by systematic reintroduction to identify triggers.<br /><br />3. Implementation requires collaboration among gastroenterologists, allergists, nurses, and dietitians to provide dietary education and ensure effective patient management.<br /><br />4. The process involves initial elimination, followed by reintroduction phases with intermittent endoscopies to monitor histologic responses.<br /><br />5. Nutritional balance is vital during the diet; alternative safe foods should provide needed nutrients. Careful label reading is crucial to avoid hidden sources of allergens.<br /><br />6. Practical tips for patients include using safe dining practices, managing cross-contamination risks, and maintaining nutrition through monitoring and supplements.<br /><br />The article emphasizes a tailored approach to dietary therapy, offering advantages over medical treatments by addressing the root cause and providing patients more control over their EoE management. A multidisciplinary method ensures successful implementation and enhances patient outcomes.

Keywords

Eosinophilic Esophagitis

Dietary Therapy

Six-Food Elimination Diet

Food Allergens

Remission

Nutritional Balance

Multidisciplinary Approach

Gastroenterologists

Patient Management

Chicago Experience