Pediatric Gastroenterology, Hepatology & Nutrition

  • 제23권1호
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  • Pages.79-88
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  • 2020
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  • 2234-8646(pISSN)
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  • 2234-8840(eISSN)
대한소아소화기영양학회 (The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition)
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Efficacy of Dairy Free Diet and 6-Food Elimination Diet as Initial Therapy for Pediatric Eosinophilic Esophagitis: A Retrospective Single-Center Study

  • Wong, Jonathan (Department of Pediatrics, University of Connecticut School of Medicine) ;
  • Goodine, Sue (Department of Pediatrics, Division of Digestive Diseases, Hepatology and Nutrition, Connecticut Children's Medical Center) ;
  • Samela, Kate (Department of Pediatrics, Division of Digestive Diseases, Hepatology and Nutrition, Connecticut Children's Medical Center) ;
  • Vance, Katherine S. (Department of Pediatrics, Division of Digestive Diseases, Hepatology and Nutrition, Connecticut Children's Medical Center) ;
  • Chatfield, Beth (Department of Pediatrics, Division of Digestive Diseases, Hepatology and Nutrition, Connecticut Children's Medical Center) ;
  • Wang, Zhu (Department of Pediatrics, University of Connecticut School of Medicine) ;
  • Sayej, Wael N. (Department of Pediatrics, University of Connecticut School of Medicine)
  • 투고 : 2019.06.17
  • 심사 : 2019.10.14
  • 발행 : 2020.01.15
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초록

Purpose: Management of eosinophilic esophagitis (EoE) varies from center to center. In this study, we evaluated the effectiveness of a dairy-free diet (DFD) and the 6-Food Elimination Diet (SFED) as initial therapies for the treatment of EoE in our practice. Methods: This was a retrospective study of children who had been treated for EoE at Connecticut Children's Medical Center, Hartford, CT, USA. Pre- and post-treatment endoscopy findings and histology results of patients treated with DFD or SFED were examined. Results: One hundred fifty-two patients (age 9.2±5.2 years, 76.3% male, 69.7% caucasian) met the inclusion criteria for initial treatment with DFD (n=102) or SFED (n=50). Response for DFD was 56.9% and for SFED was 52.0%. Response based on treatment duration (<10, 10-12, and >12 weeks) were 81.8%, 50.0%, and 55.1% for DFD, and 68.8%, 50.0%, and 40.0% for SFED. Response based on age (<6, 6-12, and >12 years) were 59.3%, 42.9%, and 67.5% for DFD, and 36.4%, 58.8%, and 72.7% for SFED. In patients treated with DFD, concomitant proton pump inhibitor (PPI) administration resulted in improved outcomes (p=0.0177). Bivariate regression analysis showed that PPI with diet is the only predictor of response (p=0.0491), however, there were no significant predictors on multiple regression analysis. Conclusion: DFD and SFED are effective first line therapies for EoE. DFD should be tried first before extensive elimination diets. Concomitant therapy with PPI's may be helpful.

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참고문헌

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  2. A Clinical Perspective on the Dietary Therapies for Pediatric Eosinophilic Esophagitis: The Gap Between Research and Daily Practice vol.12, 2020, https://doi.org/10.3389/fimmu.2021.677859
  3. Dietary Management of Eosinophilic Esophagitis: Tailoring the Approach vol.13, pp.5, 2020, https://doi.org/10.3390/nu13051630
  4. Eosinophilic Esophagitis and IgG4: Is There a Relationship? vol.66, pp.12, 2020, https://doi.org/10.1007/s10620-020-06788-0