Assessing Adherence and Barriers to Long-Term Elimination Diet Therapy in Adults with Eosinophilic Esophagitis

Wang, Ryan; Hirano, Ikuo; Doerfler, Bethany; Zalewski, Angelika; Gonsalves, Nirmala; Taft, Tiffany

doi:10.1007/s10620-018-5045-0

Cited by 73 publications

(51 citation statements)

References 34 publications

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“…[42][43][44][45][46] In addition, they have related strategies for implementing a dietary plan, the effect of the diet treatment on quality of life, and need for maintenance therapy. [47][48][49]…”

Section: Clinical Effectsmentioning

confidence: 99%

Advancing patient care through the Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR)

Aceves

Collins

Rothenberg

et al. 2020

Journal of Allergy and Clinical Immunology

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Recent advances in rare disease research are accelerated by the work of consortia that have been supported by the National Institutes of Health. Development of such consortia rely on multidisciplinary relationships and engagement with patient advocacy groups, as well as the National Institutes of Health and industry and academic partners. In this rostrum we present the development of such a process that focuses on eosinophilic gastrointestinal diseases. Principal investigators, patient advocacy groups, research assistants, and trainees work together to perform natural history studies that promote clinical trial readiness tools, conduct clinical trials, train a new generation of investigators, and perform innovative pilot studies.

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Section: Clinical Effectsmentioning

confidence: 99%

Advancing patient care through the Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR)

Aceves

Collins

Rothenberg

et al. 2020

Journal of Allergy and Clinical Immunology

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“…Incomplete symptom relief on maintenance diet, social challenges, and diet-related anxiety were cited as factors influencing adherence to the diet. 102 Although eliminating the long-term need for pharmacologic therapy, chronic dietary therapy in EoE is not without potential adverse effects. Some of the side effects include potential nutrition deficiency, decreased QOL, psychological impact of a limited diet, risk of development of eating disorders, and increased cost and complexity of food sourcing.…”

Section: Barriers To Dietary Therapy and Long-term Elimination Dietmentioning

confidence: 99%

Management of Eosinophilic Esophagitis: Dietary and Nondietary Approaches

Chen

2020

Nut in Clin Prac

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Eosinophilic esophagitis (EoE) is an allergen‐driven chronic inflammatory condition, characterized by symptoms related to esophageal dysfunction and confirmed histologically by esophageal mucosal eosinophilia. Since its first description in the 1990s, the incidence and prevalence of EoE have been on the rise. It is known to affect all ages of various ethnic backgrounds and both sexes; however, it is most seen in White males. Children with EoE often present with abdominal pain, nausea, vomiting, and failure to thrive, whereas adults with EoE typically present with dysphagia and food impaction. Diagnosis of EoE requires histologic confirmation of elevated esophageal eosinophils in a symptomatic patient, and only after secondary causes have been excluded. Because EoE is a chronic and progressively fibrostenotic disease, treatment goals include resolution of symptoms, induction and maintenance of disease remission, and prevention and possibly reversal of fibrostenotic complications, while minimizing treatment‐related adverse effects and improving quality of life. Treatment strategies include the “3 D's”—drugs, diet, and dilation. Standard drug therapies include proton‐pump inhibitors and topical corticosteroids. Dietary therapies include elemental diet, allergy testing–directed elimination diet, and empiric elimination diets. Endoscopic esophageal dilation for EoE strictures can alleviate esophageal symptoms but has no effect on mucosal inflammation. Recent progress in EoE research has made possible evidence‐based clinical guidelines. Ongoing pharmacologic trials show promise for novel biologic agents in the treatment of refractory EoE.

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“…Allergen avoidance and dietary restriction need to be conducted carefully to ensure maintenance of nutritional wellness. Drawbacks of diet therapy can include increased anxiety over diet therapy and outcomes, weight loss, multiple endoscopic procedures, and possible micronutrient deficiencies (Wang et al 2018). Expert panel guidelines support patients working with a RD trained in food allergies to prevent possible nutritional deficiencies (Dellon et al 2013).…”

Section: Determining Nutritional Statusmentioning

confidence: 99%