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Open Access Highly Accessed Case report

Nutritional management of Eosinophilic Gastroenteropathies: Case series from the community

Alfred Basilious1 and Joel Liem2*

Author Affiliations

1 Department of Biology, University of Windsor, 401 Sunset Avenue, Windsor, N9B 3P4, Canada

2 Allergy and Clinical Immunology/Pediatrics, Schulich School of Medicine and Dentistry - Windsor Allergy Asthma Education Centre, 1407 Ottawa Street, Windsor, N8X 2G1, Canada

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Allergy, Asthma & Clinical Immunology 2011, 7:10  doi:10.1186/1710-1492-7-10

Published: 30 May 2011

Abstract

Eosinophilic gastroenteropathies, such as eosinophilic esophagitis and eosinophilic colitis, have classically been treated with swallowed inhaled corticosteroids or oral corticosteroids. More recent studies have found elimination and elemental diets to be effective treatment alternatives to steroids. In this case series we describe the treatment of three children using nutritional management in a community setting. Elimination diets and elemental diets based on patch testing and skin prick tests reduced the eosinophil counts to normal levels in all three children. Food items which tested positive were then reintroduced while symptoms and eosinophil counts were monitored. Nutritional management of eosinophilic esophagitis and eosinophilic colitis was found to be effective in reducing symptoms. However, obstacles facing patients who choose this type of therapy include limitations due to the cost of repeated endoscopies, palatability of elimination/elemental diets and the availability of subspecialists trained in management (e.g. Allergy, Gastroenterology, and Pathology). It may be a worthwhile endeavour to overcome these obstacles as nutritional management minimizes the potential long-term effects of chronic steroid therapy.