Modified Elimination Diet May Be Effective in Children With Eosinophilic Gastrointestinal Disorders


Based on their retrospective findings, the researchers suggest that this diet is a potentially effective option for those patients who may face difficulties with other elimination diets.

Specialized elimination diets may be a potential option for children with non-esophageal eosinophilic gastrointestinal disorders, a patient group for whom effective dietary therapy is being explored.

A modified 6-food elimination diet consisting of amino acid-based hypoallergenic foods was tolerated in all patients who adhered to the diet throughout the induction phase, with no clinical improvement and no significant safety signals. Based on their retrospective findings, the researchers suggest that this diet is a potentially effective option for those patients who may face difficulties with other elimination diets.

“Non-IgE-dependent allergic inflammation caused by food allergens is considered one of the important causes of non-EoE EGID, so establishing an effective diet is being pursued,” the researchers wrote. increase. “Diet therapy is expected not only to temporarily suppress inflammation, but also as a radical treatment that eliminates the cause of the disease. A six-food elimination diet (SFED), which eliminates six major food groups from milk, eggs, meat, nuts, soybeans, and seafood, has been studied.It is an established treatment option for EoE and has been used for non-EoE EGID. It is frequently used in case reports and case series.”

Potential drawbacks of the SFED diet, such as the difficulty of sustaining it for more than a few days, and the fact that some patients do not improve their diet, the researchers found that by eliminating rice and 10 additional foods, they added a rainbow of amino acids. I researched elimination diets. Acid-based formulas, potatoes, vegetables and fruits.

This group reviewed the medical records of pediatric patients aged 2 to 17 years after following a modified SFED diet between January 2010 and December 2018. Twenty-three patients were initially enrolled in the study, four of whom improved with other treatments. Seven patients were followed for intervention, with 1-3 improving with food elimination and 6 with her 6-7 food elimination.

Six patients remained on the diet during the first 14 days (induction phase), five patients had symptoms before starting the diet, and all were asymptomatic after 14 days.

Although the diet was deficient in fat and selenium, none of the patients showed signs of malnutrition.5 of the 7 patients lost weight, with a median weight change of -0.6 kg (range -1.3 to 1.9 kg). The researchers explained that this was probably due to an increase in serum proteins, which resulted in less edema. The researchers noted that the weight of these five of her patients recovered through long-term observation.

All four patients with hypoproteinemia showed improvement in serum albumin. According to the researchers, the findings suggest reduced inflammation of the intestinal mucosa, halted protein leakage from the stomach and intestines, and improved absorption of nutrients from the small intestine. A decrease in absolute eosinophil counts was also demonstrated in patients.

“The following paper describes the results of the reintroduction phase of Rainbow ED. There is a need to develop better-tasting restricted diets. Sweets and treats are an important pastime, especially for children, and safe ingredients should be used.” “A randomized controlled trial comparing SFED with Rainbow ED should be conducted to clarify the effects of Rainbow ED.” To further narrow down , we need to conduct nationwide long-term food challenge trials to more thoroughly identify causative foods.”

reference

Nagashima M, Yamamoto M, Inuzuka M, et al. Tolerability and safety of a new elimination diet for eosinophilic gastritis and duodenitis in children. Allergol IntPublished online November 19, 2022. doi: 10.1016/j.alit.2022.11.001



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