In children, eosinophilic esophagitis is predominantly, but not exclusively, a food-hypersensitivity disorder.
A crystalline amino acid-based elemental diet formula currently remains the most effective nutritional treatment in inducing clinical and histologic remission.
However, compliance with an exclusive, poor-tasting liquid formulation is difficult.
Dr Amir Kagalwalla and colleagues from Illinois conducted a retrospective observational study of children with eosinophilic esophagitis evaluated during 2 different time periods.
The research team assessed the short-term clinical and histologic responses of 2 cohorts.
The team reported that during the first time period, children were treated with the standard 6-food elimination diet.
During the second time period, the children were treated with the elemental diet.
|74% in the elimination diet group achieved improvement of esophageal inflammation|
|Clinical Gastroenterology & Hepatology|
The researchers treated 35 of 60 eligible children with a diet excluding cow-milk protein, soy, wheat, egg, peanut, and seafood.
All other table foods were allowed.
The team treated 25 exclusively with elemental diet.
Repeat esophageal biopsy specimens were obtained at least 6 weeks later.
The researchers found that 74% in the elimination diet group and 88% in the elemental diet group achieved significant improvement of esophageal inflammation.
The pretreatment and posttreatment peak eosinophil counts for the elimination diet were 80 and 14 and 59 and 4 for the elemental diet group, respectively.
Dr Kagalwalla's team concludes, “Elimination diet treatment was associated with clinical and histologic improvement in eosinophilic esophagitis in an observational study.”
“It offers advantages of better acceptance, cost, and compliance than elemental diet and should be considered as an option in the initial management of children with eosinophilic esophagitis.”