Tutorial: Nutrition Therapy in Eosinophilic Esophagitis-Outcomes and Deficiencies

Area of Science:

• Gastroenterology
• Immunology
• Allergy

Background:

• Eosinophilic esophagitis (EoE) is a chronic immune-mediated esophageal disease.
• Symptoms of esophageal dysfunction in EoE vary significantly with patient age.
• Untreated EoE can lead to esophageal remodeling, fibrosis, and stricture formation.

Purpose of the Study:

• To summarize the diagnosis, triggers, and management strategies for eosinophilic esophagitis.
• To highlight the role of food antigens and dietary interventions in EoE.
• To emphasize the importance of a multidisciplinary approach in managing EoE.

Main Methods:

• Diagnosis involves upper endoscopy with esophageal biopsies.
• Biopsies are analyzed for dense eosinophilic inflammation (≥15 eosinophils/high-power field).
• Identification of common food antigen triggers: dairy, wheat, egg, and soy.

Main Results:

• EoE is characterized by eosinophilic inflammation in the esophagus.
• Common food triggers include dairy, wheat, egg, and soy.
• Management options include swallowed steroids and dietary elimination.

Conclusions:

• EoE requires a comprehensive management strategy.
• Dietary elimination diets have specific nutritional implications.
• Swallowed steroid therapy may necessitate nutritional support for growth and intake.
• A multidisciplinary team, including a dietitian, is crucial for effective EoE care.