Food elimination diet identifies causes of difficulty swallowing and swelling of the throat
Public release date: 20-Jun-2012
Contact: Alissa J. Cruz
media@gastro.org
301-272-1603
American Gastroenterological Association
Food elimination diet identifies causes of difficulty swallowing and
swelling of the throat
A six-food elimination diet significantly improves symptoms in adult
patients with eosinophilic esophagitis (EoE), according to a new study
in Gastroenterology, the official journal of the American
Gastroenterological Association. In EoE, eosinophils and other
inflammatory cells cause inflammation of the esophagus in response to an
allergic stimulus. Previously thought to be a rare disease, EoE has
become one of the most common causes for dysphagia (difficulty
swallowing), heartburn and the sensation of “food stuck in the throat”
in adults. Similar to children, this study has now shown that food
allergens have a causative role in the majority of adults with EoE.
An elimination diet that identifies specific food triggers is an
effective therapeutic alternative to corticosteroids for adults with
EoE. Furthermore, the results of a reintroduction process in which these
trigger foods are added back into a patient’s diet support the fact that
food antigens are driving this response; this provides new insight into
the nature of the inflammatory response in adult EoE.
“By first eliminating, then systematically reintroducing foods in our
adult patients, we were able to identify the specific food triggers that
caused their symptoms, such as heartburn, chest pain and difficulty
swallowing, or the sensation of food being stuck in their throat,” said
Nirmala Gonsalves, MD, of Northwestern University and the lead author of
this study. “Given the poor sensitivity of skin prick testing and lack
of history of food allergy or intolerance, the six-food elimination diet
with reintroduction is the only reliable method to date to identify food
triggers in adult eosinophilic esophagitis and should allow us to better
tailor diet to individual patients for long-term management.” View a
video abstract in which Dr. Gonsalves discusses her study findings.
A diet that eliminates all of the six most commonly allergenic foods
(milk, soy, egg, wheat, peanuts/tree nuts and shellfish/fish)
significantly improves symptoms and reduces esophageal tissue damage
associated with EoE in adults. In fact, 78 percent of patients achieved
greater than a 50 percent reduction in peak eosinophil (white blood
cell) counts in their esophagus; dysphagia symptom scores improved
significantly after the elimination diet. Once trigger foods were
reintroduced, all patients had recurrence of their symptoms within five
days. These results suggest that EoE is likely the same disease in
children and adults.
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About the AGA Institute
The American Gastroenterological Association is the trusted voice of the
GI community. Founded in 1897, the AGA has grown to include 17,000
members from around the globe who are involved in all aspects of the
science, practice and advancement of gastroenterology. The AGA Institute
administers the practice, research and educational programs of the
organization. www.gastro.org.
About Gastroenterology
Gastroenterology, the official journal of the AGA Institute, is the most
prominent scientific journal in the specialty and is in the top 1
percent of indexed medical journals internationally. The journal
publishes clinical and basic science studies of all aspects of the
digestive system, including the liver and pancreas, as well as
nutrition. The journal is abstracted and indexed in Biological
Abstracts, Current Awareness in Biological Sciences, Chemical Abstracts,
Current Contents, Excerpta Medica, Index Medicus, Nutrition Abstracts
and Science Citation Index. For more information, visit
http://www.gastrojournal.org.
Nebraska LEAP Dietitian 