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Update on dietary therapy for eosinophilic esophagitis in children and adults.
Molina-Infante, Javier; Gonzalez-Cordero, Pedro Luis; Arias, Angel; Lucendo, Alfredo J.
Afiliación
  • Molina-Infante J; a Department of Gastroenterology , Hospital Universitario San Pedro de Alcantara , Caceres , Spain.
  • Gonzalez-Cordero PL; b Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD) , Madrid , Spain.
  • Arias A; a Department of Gastroenterology , Hospital Universitario San Pedro de Alcantara , Caceres , Spain.
  • Lucendo AJ; b Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD) , Madrid , Spain.
Expert Rev Gastroenterol Hepatol ; 11(2): 115-123, 2017 Feb.
Article en En | MEDLINE | ID: mdl-27998193
INTRODUCTION: Eosinophilic esophagitis (EoE) is a chronic inflammatory esophageal disease triggered predominantly, but not excusively, by food antigens. Elimination diet thus remains the only therapy targeting the cause of the disease. Importantly, EoE is a unique form of non-IgE mediated food allergy, largely dependant upon delayed, cell-mediated hypersensitivity. Areas covered: A comprehensive review of literature to summarize and update the most relevant advances on dietary therapy for pediatric and adult EoE patients is conducted. Expert commentary: None of the currently available food allergy tests adequately predict food triggers for EoE, especially in adults. Elemental diet (exclusive feeding with aminoacid-based formulas) and empiric six-food elimination diet, withdrawing cow´s milk, wheat, egg, soy, nuts and fish/seafood for 6 weeks, have consistently shown the best cure rates. However, their high level of restriction and need for multiple endoscopies (top-down approach) have been a deterrent for patients and physicians. Less restrictive empiric schemes, like a four-food (animal milk, gluten-containing cereals, egg, legumes) or a two-food (animal milk and gluten-containing cereals) elimination diet have lately shown encouraging results. Therefore, a novel step-up strategy (2-4-6) may enhance patient uptake and promptly identify most responders to empiric diets with few food triggers, besides saving unnecessary dietary restrictions and endoscopic procedures.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Esofagitis Eosinofílica / Hipersensibilidad a los Alimentos / Hipersensibilidad Tardía Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Child / Humans Idioma: En Revista: Expert Rev Gastroenterol Hepatol Asunto de la revista: GASTROENTEROLOGIA Año: 2017 Tipo del documento: Article País de afiliación: España

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Esofagitis Eosinofílica / Hipersensibilidad a los Alimentos / Hipersensibilidad Tardía Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Child / Humans Idioma: En Revista: Expert Rev Gastroenterol Hepatol Asunto de la revista: GASTROENTEROLOGIA Año: 2017 Tipo del documento: Article País de afiliación: España