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01-09-2018 | Editorial

Topical Steroids and Elimination Diets for EoE: Happier Together?

Author: Carla M. Davis

Published in: Digestive Diseases and Sciences | Issue 9/2018

Excerpt

Eosinophilic esophagitis (EoE) is an inflammatory esophageal disease triggered by ingestion of food allergens, resulting in symptoms such as heartburn, abdominal pain, nausea, vomiting, and dysphagia. Symptomatic, endoscopic, and histologic remission is achieved after treatment with either topical steroids or dietary elimination of the top 4 or 6 most causative foods (cow’s milk, egg, soy, wheat, nuts, and seafood) [1]. There has been limited study of the efficacy of the combination of these two approaches [2]. Moreover, there are many questions and controversies regarding a combination therapeutic approach. …

Dellon ES, Gonsalves N, Hirano I, et al. ACG clinical guideline: evidenced based approach to the diagnosis and management of esophageal eosinophilia and eosinophilic esophagitis (EoE). Am J Gastroenterol. 2013;108:679–692.CrossRefPubMed

Constantine G, Seth N, Chokshi N, et al. Combination steroid and test-based food elimination for eosinophilic esophagitis: a retrospective analysis. J Pediatr Gastroenterol Nutr. 2017;64:933–938.CrossRefPubMedPubMedCentral

Reed CC, Safta AM, Qasem S, Almond MA, Dellon ES, Jensen ET. Combined and alternating topical steroids and food elimination diet for the treatment of eosinophilic esophagitis. Dig Dis Sci. https://doi.org/10.1007/s10620-018-4931-9.

Colson D, Kalach N, Soulaines P, et al. The impact of dietary therapy on clinical and biologic parameters of pediatric patients with eosinophilic esophagitis. J Allergy Clin Immunol Pract. 2014;2:587–593. https://doi.org/10.1016/j.jaip.2014.05.012.CrossRefPubMed

Chehade M, Aceves SS, Furuta GT, Fleischer DM. Food allergy and eosinophilic esophagitis: what do we do? J Allergy Clin Immunol Pract. 2015;3:25–32. https://doi.org/10.1016/j.jaip.2014.11.009.CrossRefPubMed

Liacouras CA, Furuta GT, Hirano I, et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011;128:3–20.CrossRefPubMed

Kagalwalla AF, Wechsler JB, Amsden K, et al. Efficacy of a 4-food elimination diet for children with eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2017;15:1698–1707.e7. https://doi.org/10.1016/j.cgh.2017.05.048.CrossRefPubMed

Kagalwalla AF, Sentongo TA, Ritz S, et al. Effect of six-food elimination diet on clinical and histologic outcomes in eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2006;4:1097–1102.CrossRefPubMed

Warners MJ, Vlieg-Boerstra BJ, Bredenoord AJ. Elimination and elemental diet therapy in eosinophilic oesophagitis. Best Pract Res Clin Gastroenterol. 2015;29:793–803. https://doi.org/10.1016/j.bpg.2015.06.013.10.CrossRefPubMed

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Lynch MK, Avis KT, Dimmitt RA, Goodin BR. Topical review: eosinophilic esophagitis in children: implications for health-related quality of life and potential avenues for future research. J Pediatr Psychol. 2015;40:727–732.CrossRefPubMedPubMedCentral

Title: Topical Steroids and Elimination Diets for EoE: Happier Together?
Author: Carla M. Davis
Publication date: 01-09-2018
Publisher: Springer US
Published in: Digestive Diseases and Sciences / Issue 9/2018
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI: https://doi.org/10.1007/s10620-018-5055-y

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