Dietary Treatment for Eosinophilic Disorders

Diet is a treatment option for eosinophilic disorders, including eosinophilic esophagitis (EoE), eosinophilic gastritis (EoG), eosinophilic enteritis (EoN) and eosinophilic colitis (EoC). The Cincinnati Center for Eosinophilic Disorders (CCED) at Cincinnati Children's provides nutrition information, consultation and resources for patients with an eosinophilic disorder and their families.

Common Dietary Therapies

An elemental diet is achieved via the use of nutritionally complete, amino acid-containing formulas. These formulas are referred to as "elemental formulas" because the protein in the formula is in the form of amino acids rather than whole, intact protein. Amino acids are the basic building blocks of protein, and the body breaks down proteins into amino acids during the process of digestion. Allergic reactions can develop against intact or partially broken down protein, but not against amino acids.

Elemental formulas, when taken in the prescribed amount, can provide all of the calories, vitamins and minerals that a person needs. There is a range of elemental formulas offered by Abbot Nutrition, Nutricia, Nestle, and Mead Johnson Nutrition.

A six-food elimination diet involves avoiding all foods that contain the six most commonly implicated dietary antigens in the United States, i.e. milk, soy, wheat, eggs, fish (and shellfish) and peanuts (and tree nuts), regardless of allergy testing results.

An elimination diet involves avoiding specific foods that have been implicated in causing an eosinophil-associated gastrointestinal disorder (EGID). These foods are usually identified by skin prick testing. At Cincinnati Children’s, we have used skin test-directed diets as treatment in the past, but using skin test-directed diets is no longer our current practice.

Food Trials

Food trials are used to determine what specific foods trigger a patient’s symptoms, with the goal of adding back non-triggering foods into the diet. In general, food trials consist of eating the trial food in a specified amount and frequency over a period of time. The serving size, frequency of consumption and length of the trial vary by the patient age and the trial food. To determine whether a trialed food is tolerated, disease activity is assessed at the end of the trial period by endoscopy and presenting symptoms.

The Three "A's" to Dietary Therapy Success

There is nothing easy about following any type of dietary therapy. However, with the support of their families and our team, many patients have successfully adhered to and used dietary therapy. These patients commonly practice the three "A's" to dietary therapy success:

  • A positive Attitude and willingness to undertake (the therapy)
  • Attention to detail
  • Anticipation of events involving food

**Testing and treatment for food-related allergies should be guided with the supervision of a trained physician in the field.

How to Read a Label For Food Allergies

Child eating.

Whether your child has received a new food allergy diagnosis, or you are a seasoned food allergy parent, reading food labels has its challenges.

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Our Dietitians

Our dietitians, such as Alison Cassin, MS, RD, LD and Meghan McNeill, MS, RD, LD, work closely with patients with eosinophilic disorders.

Research for Dietary Planning

Family support & resources for patients with eosinophilic esophagitis.

Members of our center's multidisciplinary team published a manuscript evaluating the comparative effectiveness of dietary therapy and the utility of skin tests to direct dietary planning in pediatric eosinophilic esophagitis.

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Steroids treatment.

Medications are a primary treatment for eosinophilic disorders. 

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