Eosinophilic esophagitis is a chronic disease, driven by food allergens.
Elemental diets are effective for the management of children with eosinophilic esophagitis, but studies on the effect of elemental diets in adults are scarce and poor palatability challenges dietary adherence.
Dr Warners and colleagues assessed the effects of an elemental diet on the inflammation, symptoms and endoscopic signs in adult eosinophilic esophagitis patients.
In this prospective study, the researchers evaluated 21 patients with active eosinophilic esophagitis, confirmed by biopsies showing =15 eosinophils per microscopic high power field, and symptoms of esophageal dysfunction were included.
Patients underwent endoscopy before and 4 weeks after diet.
Histological disease activity, and endoscopic signs were scored by physicians.
Symptoms and adherence to the diet were evaluated by questionnaires.
|81% of the patients completed the diet|
|Alimentary Pharmacology & Therapeutics|
Serum total IgE levels and total eosinophil counts were determined and the expression of inflammatory cytokines was analyzed by qPCR.
In total, the research team reported that 81% of the patients completed the diet, of whom 71% showed complete histological response, and 24% showed partial histological response.
The team found that peak eosinophil counts decreased significantly after the diet from 40 to 9 per high power field.
A marked improvement in endoscopic signs was observed.
The researchers found that symptoms decreased significantly in all subjects, and 88% became completely asymptomatic.
In 82% of patients, blood eosinophil count and serum IgE decreased.
Dr Warners' team concludes, "Elemental diet reduces eosinophilic inflammation and induces clinical remission in adult patients with eosinophilic esophagitis."