Eosinophilic Oesophagitis in Adults
Dietary Management of Adult Eosinophilic Oesophagitis: The efficacy of an elemental + few foods diet vs. six food elimination diet in inducing remission in adults patients with Eosinophilic Oesophagitis
University of Portsmouth
Eosinophilic Oesophagitis (EoE), is characterised by eosinophils (allergy cells) building up in the lining of the oesophagus/food pipe and looks a bit like eczema of the oesophagus.
The eosinophils cause inflammation in the oesophagus, causing the following symptoms: difficulty feeding, poor weight gain, decreased appetite, chest/abdominal pain, reflux-like symptoms, vomiting, trouble swallowing and food getting stuck; affecting quality of life.
EoE is a chronic but not life threatening disease; which can be managed successfully with diet and/or medication. However, if left untreated it may cause permanent damage to the oesophagus. There is a strong connection between food allergies and EoE. It is however very difficult to identify the foods causing EoE and clinicians are also not sure which diet strategy is the best approach. Previous studies looking at diet therapy and EoE have found that a diet based on an elemental drink improves EoE very quickly and effectively (about 90% of cases) but these diets are very hard to follow. The six food elimination diet (SFED excludes dairy, soya, eggs, wheat, peanuts, fish/shellfish) does improve EoE to some extent (about 70% of cases) and is a bit easier to follow. In order to find out if these diets are working, patients often have to undergo endoscopies which is stressful and not without risks. We are setting out to 1) trial a dietary approach “halfway” between an elemental diet and six food diet. This diet will rely on the use of an elemental drink, but also allow six foods that have not been implicated in EoE (lamb, quinoa, millet, broccoli, butternut squash, and coconut) compared to the usual six food elimination diet. In pursuit of an alternative to endoscopies, we will also be looking at other options such as the levels of immune cells (biomarkers) to indicate improvement of EoE.
South Central - Berkshire Research Ethics Committee
Date of REC Opinion
24 Jul 2014
Further Information Favourable Opinion