ArticleAsia Pacific allergy2018
Histologic improvement after 6 weeks of dietary elimination for eosinophilic esophagitis may be insufficient to determine efficacy.
Article in Asia Pacific allergy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 27 citations in OpenAlex.
- One-food versus six-food elimination diet therapy for the treatment of eosinophilic oesophagitis: a multicentre, randomised, open-label trial.The lancet. Gastroenterology & hepatology · 2023Trial
- A Novel Allergen-Specific Immune Signature-Directed Approach to Dietary Elimination in Eosinophilic Esophagitis.Clinical and translational gastroenterology · 2019Trial
- Dietary Approaches in Eosinophilic Esophagitis.Nutrients · 2026Review
- Treatment of Pediatric Eosinophilic Esophagitis: Traditional and Novel Therapies.Current gastroenterology reports · 2023Review
- Development of a Practical Guide to Implement and Monitor Diet Therapy for Eosinophilic Esophagitis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023Review
- Evidence-based treatments for eosinophilic esophagitis: insights for the clinician.Therapeutic advances in gastroenterology · 2022Review
- Illuminating Elimination Diets: Controversies Regarding Dietary Treatment of Eosinophilic Esophagitis.Digestive diseases and sciences · 2019Review
- New Developments in the Diagnosis and Treatment of Eosinophilic Esophagitis.Current treatment options in gastroenterology · 2019Review
- Spring and allergy.Asia Pacific allergy · 2018Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
backgroundElimination diets are used to treat eosinophilic esophagitis (EoE), with success (remission) defined at endoscopy and oesophageal biopsy as fewer than 15 eosinophils per high power field (HPF). Response is assessed after 6 weeks of treatment by convention, but we have observed that this period of time may be insufficient.
objectiveTo characterise a subset of patients with EoE who require prolonged (>6 weeks) of dietary therapy to achieve histologic remission.
methodsA retrospective search of electronic medical records of 2 cohorts with EoE attending the Department of Gastroenterology, University of Chapel Hill North Carolina, and Eastern Health, Melbourne Australia. Patients who underwent elimination diet, had esophageal biopsy after 6 or more weeks of dietary restriction that demonstrated ongoing esophageal inflammation (>15 eosinophils per HPF), and who then continued dietary therapy followed by repeat endoscopy demonstrating remission (<15 eosinophils per HPF) were included.
resultsSeven patients met inclusion criteria, average esophageal eosinophil counts prior to diet was 38.5 (range, 15-65). Following the initial period of diet (mean of 6 weeks and 4 days) eosinophil count decreased (average, 21.5/HPF; range 15-40/HPF). After extended dietary elimination (mean, 13 weeks; range, 7-22 weeks), histological resolution was achieved (average peak eosinophil count of 5.2; range, 0-14) in all cases. Endoscopic appearance and symptoms both improved following the initial period of dietary elimination, thereby preceding the histological resolution, and were sustained.
conclusionA subset of patients has full histologic response to prolonged elimination diet, that lags initial symptomatic and endoscopic improvement.
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