BACKGROUND & AIMS: In children, eosinophilic esophagitis (EE) is predominantly, but not exclusively, a food-hypersensitivity disorder. A crystalline amino acid-based elemental diet (ELED) 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. METHODS: This retrospective observational study assessed the short-term clinical and histologic responses of 2 cohorts of children with EE evaluated during 2 different time periods: one was treated with the standard 6-food elimination diet (SFED) and the other was treated with ELED. Of the 60 children who met the inclusion criteria and were compliant with the dietary protocol, 35 were treated with a diet excluding cow-milk protein, soy, wheat, egg, peanut, and seafood while allowing all other table foods and 25 were treated exclusively with ELED. Repeat esophageal biopsy specimens were obtained at least 6 weeks later. RESULTS: Twenty-six of 35 (74%) in the SFED group and 22 of 25 (88%) in the ELED group achieved significant improvement of esophageal inflammation (</=10 eosinophils/high-power field). The pretreatment and posttreatment peak eosinophil counts for the SFED were 80.2 +/- 44.0 and 13.6 +/- 23.8 (P < .0001) and 58.8 +/- 31.9 and 3.7 +/- 6.5 (P < .001) for the ELED group, respectively. CONCLUSIONS: SFED treatment was associated with clinical and histologic improvement in EE in an observational study. It offers advantages of better acceptance, cost, and compliance than ELED and should be considered as an option in the initial management of children with EE.
BACKGROUND & AIMS: In children, eosinophilic esophagitis (EE) is predominantly, but not exclusively, a food-hypersensitivity disorder. A crystalline amino acid-based elemental diet (ELED) 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. METHODS: This retrospective observational study assessed the short-term clinical and histologic responses of 2 cohorts of children with EE evaluated during 2 different time periods: one was treated with the standard 6-food elimination diet (SFED) and the other was treated with ELED. Of the 60 children who met the inclusion criteria and were compliant with the dietary protocol, 35 were treated with a diet excluding cow-milk protein, soy, wheat, egg, peanut, and seafood while allowing all other table foods and 25 were treated exclusively with ELED. Repeat esophageal biopsy specimens were obtained at least 6 weeks later. RESULTS: Twenty-six of 35 (74%) in the SFED group and 22 of 25 (88%) in the ELED group achieved significant improvement of esophageal inflammation (</=10 eosinophils/high-power field). The pretreatment and posttreatment peak eosinophil counts for the SFED were 80.2 +/- 44.0 and 13.6 +/- 23.8 (P < .0001) and 58.8 +/- 31.9 and 3.7 +/- 6.5 (P < .001) for the ELED group, respectively. CONCLUSIONS: SFED treatment was associated with clinical and histologic improvement in EE in an observational study. It offers advantages of better acceptance, cost, and compliance than ELED and should be considered as an option in the initial management of children with EE.
Authors: J Pablo Abonia; Carine Blanchard; Bridget Buckmeier Butz; Heather F Rainey; Margaret H Collins; Keith Stringer; Philip E Putnam; Marc E Rothenberg Journal: J Allergy Clin Immunol Date: 2010-06-09 Impact factor: 10.793
Authors: Elizabeth T Jensen; Kevin Z Huang; Hannah X Chen; Lisa E Landes; Kristen A McConnell; Mary Angie Almond; Anca M Safta; Douglas T Johnston; Raquel Durban; Laura Jobe; Carrie Frost; Sarah Donnelly; Brady Antonio; Antonio Quiros; Jonathan E Markowitz; Evan S Dellon Journal: J Pediatr Gastroenterol Nutr Date: 2019-01 Impact factor: 2.839