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April 2013, Vol. 9, No. 4, Pages 285-287 , DOI 10.1586/eci.13.15
(doi:10.1586/eci.13.15)
Emerging concepts of dietary therapy for pediatric and adult eosinophilic esophagitis
* Author for correspondence
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Eosinophilic esophagitis (EoE) is a disease of the esophagus distinguished by pronounced esophageal eosinophilia, and for which dietary antigen appears to be an important driving factor of the disease process. Multiple studies have demonstrated that food elimination diets are an effective therapy [1–4]. In addition, food reintroduction triggers relapse of the disease, suggesting an allergic mechanism to ingested foods [5–7].
Predictive values for both skin prick test (SPT) and atopy patch test (APT) have been reported [3,5,8]. However, APTs have not been standardized in an EoE population [9–11], and both SPT and APT may not be widely applicable [12]. Thus, SPTs, serum IgE tests and APTs may be adjunctive in identifying a causative food in EoE, but food triggers can only be identified by disease remission, after a specific food elimination, followed by EoE relapse upon reintroduction of that food [13]. Several studies published in the past year, of both adult and pediatric patients with EoE, have compared skin test-directed diet therapy with six-food elimination diet (SFED) therapy as well as attempted to identify causative foods [14–16]. Herein, we summarize the results of these studies and suggest a clinical approach based on collective data.
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