Pediatr Gastroenterol Hepatol Nutr.  2020 Jan;23(1):79-88. 10.5223/pghn.2020.23.1.79.

Efficacy of Dairy Free Diet and 6-Food Elimination Diet as Initial Therapy for Pediatric Eosinophilic Esophagitis: A Retrospective Single-Center Study

• Wong J
• Goodine S
• Samela K
• Vance KS
• Chatfield
• Wang Z
• Sayej WN

• KMID: 2467896
• DOI: http://doi.org/10.5223/pghn.2020.23.1.79

Abstract

PURPOSE
Management of eosinophilic esophagitis (EoE) varies from center to center. In this study, we evaluated the effectiveness of a dairy-free diet (DFD) and the 6-Food Elimination Diet (SFED) as initial therapies for the treatment of EoE in our practice.
METHODS
This was a retrospective study of children who had been treated for EoE at Connecticut Children's Medical Center, Hartford, CT, USA. Pre- and post-treatment endoscopy findings and histology results of patients treated with DFD or SFED were examined.
RESULTS
One hundred fifty-two patients (age 9.2±5.2 years, 76.3% male, 69.7% caucasian) met the inclusion criteria for initial treatment with DFD (n=102) or SFED (n=50). Response for DFD was 56.9% and for SFED was 52.0%. Response based on treatment duration ( < 10, 10-12, and >12 weeks) were 81.8%, 50.0%, and 55.1% for DFD, and 68.8%, 50.0%, and 40.0% for SFED. Response based on age ( < 6, 6-12, and >12 years) were 59.3%, 42.9%, and 67.5% for DFD, and 36.4%, 58.8%, and 72.7% for SFED. In patients treated with DFD, concomitant proton pump inhibitor (PPI) administration resulted in improved outcomes (p=0.0177). Bivariate regression analysis showed that PPI with diet is the only predictor of response (p=0.0491), however, there were no significant predictors on multiple regression analysis.
CONCLUSION
DFD and SFED are effective first line therapies for EoE. DFD should be tried first before extensive elimination diets. Concomitant therapy with PPI's may be helpful.

Keyword

Eosinophilic esophagitis; Restriction diet therapy; Proton pump inhibitors

MeSH Terms

Child
Connecticut
Diet*
Endoscopy
Eosinophilic Esophagitis*
Eosinophils*
Humans
Male
Proton Pump Inhibitors
Proton Pumps
Retrospective Studies*
Proton Pump Inhibitors
Proton Pumps

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