- For children with eosinophilic esophagitis (EoE), a dairy-free diet (DFD) works as well as the more difficult 6-food elimination diet (SFED).
- Adding proton-pump inhibitor (PPI) therapy to DFD may improve response rates.
- Prospective trial warranted.
Why this matters
- Treatment has not been standardized.
- Both a DFD and the SFED are efficacious and are frequently recommended.
- Some elimination diets are more expensive and burdensome than others.
- Response rate with DFD vs SFED: 56.9% vs 52.0%.
- Post- vs pretreatment eosinophil counts per high-powered field (all P≤.0001):
- Overall sample: 21.3±1.9 vs 45.9±2.0.
- DFD group (n=102): 20.6±2.3 vs 42.2±2.3.
- SFED group (n=50): 19.0±4.1 vs 52.4±4.2.
- Post- vs pretreatment abnormal endoscopic findings:
- Overall: 53.9% (82/152) vs 72.4% (110/152; P=.0009).
- DFD group: 52.9% (54/102) vs 69.6% (71/102; P=.0363).
- SFED group: 56.0% (28/50) vs 78.0% (39/50; P=.0005).
- Response rates did not differ by age or atopy status.
- On bivariate but not multivariate analysis, success rates among DFD patients were higher with vs without concomitant PPI treatment.
- Single-center retrospective study of children treated for EoE with either DFD or SFED (n=152).
- Outcomes: histological response.
- Funding: None disclosed.
- No compliance measures.
- PPI dosing was not noted.