New approaches to diet therapy for eosinophilic esophagitis.

Autor: Molina-Infante J; Department of Gastroenterology, Hospital Universitario de Cáceres, Cáceres.; Centro de Investigacion Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain., Mata-Romero P; Department of Gastroenterology, Hospital Universitario de Cáceres, Cáceres., Martín-Holgado D; Department of Gastroenterology, Hospital Universitario de Cáceres, Cáceres.
Jazyk: angličtina
Zdroj: Current opinion in gastroenterology [Curr Opin Gastroenterol] 2023 Jul 01; Vol. 39 (4), pp. 315-319. Date of Electronic Publication: 2023 Apr 25.
DOI: 10.1097/MOG.0000000000000940
Abstrakt: Purpose of Review: An empiric step-up (2-4-6) elimination diet remains the most common dietary approach in clinical practice when treating eosinophilic esophagitis (EoE). However, research in this field has fallen behind pharmacological therapy. This review aims to summarize novel approaches to dietary therapy for EoE.
Recent Findings: A first prospective multicenter study in 41 pediatric patients (mean age 9 years) has evaluated the efficacy of a cow's milk elimination diet. This dietary approach led to histological remission in 51% of patients, albeit a caveat is that up to 80% of patients were receiving concomitant therapy with proton pump inhibitors. In a series of 18 adult patients with documented milk-induced EoE, ingestión of 400 ml of sterilized milk (boiled for up to 20 min) daily for 8 weeks did not induce histologic relapse in two-thirds of patients.
Summary: Milk elimination diet is effective in one-half of pediatric EoE patients and should likely be the first choice in children with EoE (within a step-up dietary approach). Promising data on tolerance of sterilized milk in adults with milk-induced EoE (66%) merit further replication in children, which may radically improve quality of life for patients and their caregivers.
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Databáze: MEDLINE
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