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EoE patients achieved remission with four-food group elimination diet
Adult patients with eosinophilic esophagitis achieved clinicopathologic remission with a four-food group elimination diet, according to research data.
Studies have shown that 65% to 85% of patients who respond to a six-food group elimination diet (SFGED) have only one or two eosinophilic esophagitis (EoE) triggers, the researchers wrote, and therefore, “some dietary restrictions and endoscopies after food challenge may be unnecessary.”
To test the efficacy of a four-food group elimination diet (FFGED) in EoE patients, researchers from Spain conducted a prospective multicenter study of 52 patients (mean age, 35 years, 63% men) from September 2012 to March 2014. All patients adhered to FFGED for 6 weeks, eliminating cow’s milk, wheat, eggs and legumes, and were evaluated for clinical and histologic remission by endoscopy with esophageal biopsy. Patients who responded underwent sequential food reintroduction over 6 weeks, while nonresponders to FFGED (n=19) went on a rescue SFGED.
Clinical remission was achieved by 67% of the cohort, 54% of whom achieved histologic remission after FFGED, and dysphagia symptom scores decreased overall after FFGED (9.12 vs. 4.3; P<.001). Of nonresponders 31% achieved histologic remission after switching to SFGED and 78% of responders completed food reintroduction. Each patient had two or fewer EoE triggers, including milk for 50% of patients (as the lone trigger in 27%), egg for 36%, wheat for 31% and legumes for 18%. The combined efficacy rate for FFGED and SFGED was 72%.
“Three of every four patients achieving remission on an SFGED may achieve it on an FFGED, a less restrictive dietary intervention that requires fewer endoscopies and shortens the food reintroduction process,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.