Research has shown a strong connection between food allergies and eosinophilic esophagitis (EoE). Studies have shown that particular foods cause allergy cells to build up in the esophagus. While there are certain foods that are common EoE culprits, there is no way of knowing for sure which foods trigger EoE in a patient without allergy testing and eliminating foods from a child’s diet.
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Directed Elimination Diet
After a child has completed a full allergy work-up, our multidisciplinary EoE team uses the information from both the skin prick test and patch test to develop a directed elimination diet in which all foods the child tests positive to will be eliminated from his or her diet. The goal is to eliminate the food(s) that may be causing the eosinophils to travel to the esophagus. Because it takes time for the esophagus to heal, patients typically follow the diet for at least eight weeks. Allergy testing is not 100% accurate, and some of the foods that may be positive on testing may not be causing a child’s EoE. Our team cannot positively know what foods are causing the EoE until we see a change in the amount of allergy cells inside the esophagus.
Some children may test positive to multiple foods which are subsequently eliminated from the child's diet or may be following the 6-food elimination diet with additional foods that were positive from allergy testing. These types of diets are considered severely restricted diets because of the amount of foods that are eliminated from the patient's diet. Should this be the case, the child’s dietitian will provide detailed information on how to follow the diet and a variety of resources about available food options to ensure the child’s nutritional needs are met. An elemental formula may also be prescribed in combination with an elimination diet if it is not possible to meet nutritional requirements with an elimination diet and/or if the child has poor growth and/or weight loss.
- Fish and shellfish
- Tree nuts & peanuts
- Frequently Asked Questions About Elimination and Elemental Diets
- Grain Alternatives for When Wheat is Eliminated
- Calcium Rich Food Sources
- Understanding Food Labels
- 6-food Elimination Diet Food Overview
- 6-food Elimination Diet Food Chart
- 6-food Elimination Diet Baking Alternatives
- 6-food Elimination Diet Lunch and Snack Ideas
- 6-food Elimination Sample Meal Plans
- If the elimination diets do not help with the child's EoE symptoms, we may recommend putting the child on an elemental formula diet in which all food is removed from the child's diet. Learn more about the elemental diet.
- Approximately eight weeks after starting a diet, we will perform another endoscopy to see if the child's eosinophils have improved. If the child's scope is clean, he or she may then begin to have food reintroduced into his or her diet under the direction of the child's nurse practitioner or physician at the Eosinophilic Esophagitis Clinic. Learn more about food reintroduction.
- Some children may require medical management of their EoE symptoms with medications. Learn more about medical management of EoE.