Module 9 References-Gonsalves et al Week31_ACGVGR_Gonsalves

Gonsalves et al Week31_ACGVGR_Gonsalves_EoE3

Pdf Summary

The provided document outlines the detailed contents of a series of presentations on dietary therapy for Eosinophilic Esophagitis (EoE) held between October 23-28, 2020. Presenters include Dr. Nirmala Gonsalves, Professor of Medicine at Northwestern University, and Dr. Kathy A. Peterson. The sessions cover essential aspects of EoE dietary management, including historical perspectives, treatment protocols, reintroduction strategies, and the use of non-invasive assessment tools.<br /><br />Key points from the presentations:<br />1. **History and Evolution of Dietary Therapy for EoE**:<br />   - Explored the development and impact of various diet plans over the years, such as the Six-Food Elimination Diet (SFED), Elemental Diet, and newer approaches like the 2-4-6 diet.<br /><br />2. **Types of Dietary Therapy**:<br />   - **Elemental Diets**: Demonstrated the highest efficacy (91%) but presented adherence challenges.<br />   - **Targeted Diets**: Based on specific allergy tests and had a 72% efficacy.<br />   - **Empiric Elimination Diets**: Broader dietary exclusions with 45% efficacy.<br /><br />3. **Reintroduction Protocols**:<br />   - Detailed protocols include phased reintroduction of foods such as seafood, nuts, soy, eggs, wheat, and dairy, with intervals for observing histologic responses.<br /><br />4. **Non-Invasive Assessments**:<br />   - Techniques like the Esophageal String Test, unsedated transnasal endoscopy, and Cytosponge were discussed as useful alternatives to traditional endoscopies.<br /><br />5. **Practical Considerations for Implementing Diet Plans**:<br />   - Highlighted the need for thorough dietary consultations, patient education, and addressing adherence issues influenced by social situations, anxiety, and the effectiveness of the diet in symptom management.<br /><br />6. **Challenges and Unmet Needs**:<br />   - Addressed the need for better compliance, personalized dietary approaches based on patient goals, and the potential role of allergy testing.<br /><br />7. **Tips and Long-Term Strategies**:<br />   - Emphasized setting up patients for success with detailed protocols, ongoing support, and utilizing topical corticosteroids when strict adherence to diet changes is challenging.<br /><br />8. **Conclusions**:<br />   - Dietary therapy is effective for managing EoE. Multiple dietary strategies are available and should be tailored to individual patient preferences. Long-term maintenance and continuous monitoring are crucial for sustained success.<br /><br />The presenters conclude by reinforcing the effectiveness of dietary therapy for EoE and the importance of patient-centric tailored approaches, supported by non-invasive monitoring techniques.

Keywords

Eosinophilic Esophagitis

dietary therapy

Six-Food Elimination Diet

Elemental Diet

reintroduction protocols

non-invasive assessments

Esophageal String Test

diet adherence

personalized dietary approaches

long-term strategies