Eosinophilic esophagitis (EoE) is a chronic immuno- or antigen-mediated condition leading to eosinophilic inflammation of the esophagus. As a result, esophageal dysfunction develops, presenting in adults mainly with dysphagia and heartburn. In children, the main symptoms are abdominal pain, refractory reflux complaints, nausea and vomiting. Treatment with oral topical corticosteroids and proton-pump inhibitors are well-established therapeutic tools. Dietary restrictions have a proven beneficial effect on clinical symptoms. Elimination diets are not without risk and can impact nutritional status, eating pleasure and quality of life. With adequate selection and balance, dietary therapy can be effective and the adverse effects on lifestyle can be minimized. The review presents a brief overview of the possibilities and guidance for dietary therapy of this increasingly recognizable disease.
Aceves SS. Dietary management of eosinophilic esophagitis. UpToDate. Aug 2020.
Attwood SE, Smyrk TC, Demeester TR, Jones JB. Esophageal eosinophilia with dysphagia. A distinct clinicopathologic syndrome. Dig Dis Sci. 1993;38(1):109-16. doi: 10.1007/BF01296781.
Futura GT, Katzka DA. Eosinophilic Esophagitis. N Engl J Med. 2015; 373(17):1640-8. doi:10.1056/NEJMra1502863.
Groetch M, Venter C, Skypala I, Vlieg-Boersta B, Grimshaw K, Durban R, et al. Dietary Therapy and Nutrition Management of Eosinophilic Esophagitis: A Work Group Report of the American Academy of Allergy, Asthma, and Immunology. J Allergy Clin Immunol Pract. 2017;5:312-24.
Hirano I, Futura GT. Approaches and challenges to management of pediatric and adult patients with eosinophilic esophagitis. Gastroenterology. 2020;158:840-51. doi: 10.1053/j.gastro.2019.09.052.
Iglesia EGA, Reed CC, Nikolai E, Dellon ES. Dietary elimination therapy is effective in most adults with eosinophilic esophagitis responsive to proton pump inhibitors. Clin Gastroenterol Hepatol. 2020;18(7):1638-40.e2. doi: 10.1016/j.cgh.2019.08.010.
Khan S, Guo X, Liu T, Iqbal M, Jiang K, Zhu L, et al. An Update on eosinophilic esophagitis: etiological factors, coexisting diseases, and complications. Digestion. 2020 Jun 22:1-15. doi: 10.1159/000508191.
Kumar S, Choi SS, Gupta SK. Eosinophilic esophagitis: current status and future directions. Pediatr Res. 2020;88(3):345-7. doi: 10.1038/s41390-020-0770-4.
Lucendo AJ, Molina-Infante J, Arias Á, von Arnum U, Bredenoord AJ, Bussmann C. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United European Gastroenterol J. 2017;5(3):335-58. doi:10.1177/2050640616689525.
Miehlke S, Attwood S. Eosinophilic Esophagitis (EoE). Dr. Falk Pharma GmbH, Germany, 2018.
Schuyler AJ, Wilson JM, Tripathi A, Commins SP, Ogbogu PU, Kruzsewski PG, et al. Specific IgG4 antibodies to cow’s milk proteins in pediatric patients with eosinophilic esophagitis. J Allergy Clin Immunol. 2018; 142(1): 139-148.e12. doi: 10.1016/jaci.2018.02.049.
