The six food elimination diet for eosinophilic esophagitis

The inflammation seen in eosinophilic esophagitis can lead to a narrowing of the esophagus that often makes it difficult to swallow and can lead to food becoming lodged ther. Recent research has shown that the longer a person has increased eosinophils (the white blood cells that are increased in allergic disorders) in the esophagus, the more likely that person is to develop this narrowing. So, treatment should begin during childhood in an effort to prevent this narrowing from occurring at all. 

The Six-Food Elimination Diet

A study from the Northwestern Pediatric Gastroenterology Division showed that removing 6 foods from the diet (milk, eggs, wheat, soy, peanuts/tree nuts and seafood) resulted in symptom and biopsy improvement in 74% of the children who were treated with this diet. Afterwards, the foods were slowly reintroduced back into the diet. As a result, 11% of the children had no reaction to the foods; 72% reacted to 1 food; 8% reacted to 2 foods; and 8% reacted to 3 foods. Interestingly, cow's milk was the one food that caused a reaction 74% of the time. Below is a table of each food that caused a reaction after reintroduction. 

Foods involved in Eosinophilic Esophagitis

                      Percent of Patients Reacting

Milk 74%

 Wheat 26%

Eggs 17%

Soy 10%

Peanuts   6%

When the same diet was used in adults, only 50% responded in the same way.  So there does seem to be a difference in kids and adults with EoE

Bottom Line: Diet plays an important role for most patients. Eliminating common foods that cause allergies (the 6 food elimination diet) can make a huge difference in EoE. Milk may be a good food to eliminate first as it caused a reaction in 74% of children with EoE. 

Tags: EoE, esophagus, inflammation, white blood cells, eosinophiles, allergies, food allergies, milk, dairy, nuts, peanuts, tree nuts, soy, wheat, eggs, seafood, research, six food elimination diet, 

*A Kagalwalla et al, JPGN 53: 145, 2011