A 1-Food Elimination Diet Can Improve Symptoms in Pediatric Eosinophilic Esophagitis

Eliminating milk as part of the 1-food elimination diet can positively impact the histologic remission rate of pediatric eosinophilic esophagitis (EoE) as well as the quality of life of children with the disease, according to a new study presented at Digestive Disease Week. The authors suggest the less-restrictive 1-food elimination diet be considered first-line treatment for pediatric EoE.

The investigators randomly assigned 38 participants to follow a 1-food elimination diet and 25 participants to follow a 4-food elimination diet for 12 weeks. The participants—all aged 6 to 17 years—had active EoE and symptoms of esophageal dysfunction.

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While the change in total symptom score was greater among participants who followed a 4-food than a 1-food elimination diet (-25.0 points vs -14.3 points using the Pediatric EoE Symptom Score, v2.0), both diets induced significant improvements in participants’ symptom scores.

Participants in both groups also had similar histologic remission rates—44.1% among participants in the 1-food elimination diet group and 41.2% among the 4-food elimination diet group—as well as significant decreases in the severity and extent of histologic abnormalities.

Participants following the 1-food elimination diet also experienced clinically significant improvements in psychosocial and emotional well-being.

The 1-food elimination diet “had a generally positive impact on quality of life. For patients seeking improvement in symptoms and quality of life, a one food (milk) elimination diet should be considered a reasonable first treatment option,” the study authors concluded.

—Colleen Murphy

Reference:

Kliewer K, Aceves SS, Atkins D, et al. Efficacy of 1-food and 4-food elimination diets for pediatric eosinophilic esophagitis in a randomized multi-site study. Presented at: Digestive Disease Week; May 18-21; San Diego, CA. https://www.gastrojournal.org/article/S0016-5085(19)37223-3/pdf?referrer=https%3A%2F%2Fwww.gastrojournal.org%2Farticle%2FS0016-5085%2819%2937223-3%2Ffulltext. Accessed May 22, 2019.