Food, drug, insect sting allergy, and anaphylaxisFour-food group elimination diet for adult eosinophilic esophagitis: A prospective multicenter study
Section snippets
Patient selection and eligibility
This was a multicenter quasi-experimental study with a removed-treatment design,20 prospectively conducted at 4 Spanish hospitals between September 2012 and March 2014. Consecutive adolescents and adults older than 14 years with a diagnosis of EoE, defined by consensus guidelines1 (dysphagia/food impaction and >15 eos/hpf in esophageal biopsies unresponsive to an 8-week trial of PPI therapy), were eligible for enrollment. Patients were recruited from outpatient gastroenterology clinics.
Baseline characteristics of patients
Over the recruitment period, a total of 69 consecutive adult patients with EoE were eligible for enrollment. Seventeen patients refused the FFGED because of practical difficulties in following the diet and finally 52 patients were included. After an initial trial of the FFGED, 4 patients were lost to follow-up because they all moved out of Spain to search for a job. The flow of patients during the study and the efficacy of dietary interventions are summarized in Fig 1.
Baseline characteristics
Discussion
In this prospective multicenter study, we have proven empiric FFGED to be an effective and reproductible dietary therapy for adult patients with EoE, capable of achieving clinicopathologic remission in more than half of the patients. In addition, a rescue SFGED achieved disease remission in almost a third of the patients who had failed the FFGED, overall providing a 72% remission rate, which exactly coincides with previously reported effectiveness for empiric SFGED-based approaches in a recent
References (30)
- et al.
Eosinophilic esophagitis attributed to gastroesophageal reflux: improvement with an amino acid-based formula
Gastroenterology
(1995) - et al.
Efficacy of dietary interventions in inducing histologic remission in patients with eosinophilic esophagitis: a systematic review and meta-analysis
Gastroenterology
(2014) - et al.
Treatment of eosinophilic esophagitis with specific elimination diet directed by a combination of skin prick and patch test
Ann Allergy Asthma Immunol
(2005) - et al.
Predictive values for skin prick test and atopy patch test for eosinophilic esophagitis
J Allergy Clin Immunol
(2007) - et al.
Pediatric patients with eosinophilic esophagitis: an 8-year follow-up
J Allergy Clin Immunol
(2007) - et al.
Variable yield of allergy patch testing in children with eosinophilic esophagitis
J Allergy Clin Immunol
(2013) - et al.
Selective elimination diet based on skin testing has suboptimal efficacy for adult eosinophilic esophagitis
J Allergy Clin Immunol
(2012) - et al.
Dietary elimination therapy is an effective option for adults with eosinophilic esophagitis
Clin Gastroenterol Hepatol
(2014) - et al.
Effect of six-food elimination diet on clinical and histologic outcomes in eosinophilic esophagitis
Clin Gastroenterol Hepatol
(2006) - et al.
Elimination diet effectively treats eosinophilic esophagitis in adults: food reintroduction identifies causative factors
Gastroenterology
(2012)
Empiric 6-food elimination diet induced and maintained prolonged remission in patients with adult eosinophilic esophagitis: a prospective study on the food cause of the disease
J Allergy Clin Immunol
Comparative dietary therapy effectiveness in remission of pediatric eosinophilic esophagitis
J Allergy Clin Immunol
The management of eosinophilic esophagitis
J Allergy Clin Immunol Pract
Pollen and eosinophilic esophagitis
J Allergy Clin Immunol
Eosinophilic esophagitis: updated consensus recommendations for children and adults
J Allergy Clin Immunol
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Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest.