Eosinophilic esophagitis (EoE) is a chronic immune/
antigen-mediated
esophageal disease characterized by esophageal dysfunction and esophageal mucosal
eosinophilia.
Diet therapy is effective in the treatment of EoE in both children and adults. The role of food
allergens is well established in the pathogenesis and treatment of
eosinophilic esophagitis. Empiric elimination with a six-food elimination diet (avoiding milk, wheat, egg, soy, peanuts/tree nuts, and fish/shellfish) demonstrates remission in over 70% of adults with this disease. Dietary
therapy in adult EoE is becoming more accepted by both patients and clinicians. Dietary
therapy can be effectively implemented in clinical practice with appropriate dietary education, patient resources, and close communication with physician and clinical staff. The ability to identify specific food triggers to help tailor dietary
therapy for long-term management allows for a return to consumption of most table foods. Furthermore, the diet approach avoids the need for chronic topical
corticosteroid use and possible long-term side effects of these medications. The decision to proceed with dietary
therapy should be decided by patient preference and available resources. A collaborative and multidisciplinary approach including gastroenterologists, allergists, nurses, and dietitians is essential in the success of this approach.