BSPGHAN 2021 Virtual Annual Meeting

27- 29 April 2021

EXPERIENCES IN DIETARY MANAGEMENT OF EOSINOPHILIC OESOPHAGITIS

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Christine Spray
Christine Spray
22 days ago

Thank you for your poster. It is interesting that less than 50% of patients chose dietary treatment even with only 1 food exclusion. I wonder why this should be considered more difficult for patients with EoE to comply compared with patients diagnosed with Coeliac disease? Could the author comment? What was the endoscopic remission rate in those on PPI? When would the authors choose 6 food elimination diet over 1 -2 food elimination diet ? How long were the patients on elimination diets and how many of these patients relapsed once food groups were re-introduced

Sarah Khweir
Sarah Khweir
20 days ago

Thank you for your questions.
 
We did not ask the patients why their preference was medication, however , although there is an option for the patients, generally many do start with a PPI. In general, I have read previously that coeliac disease has been rated as one of the most burdensome conditions in terms of quality of life for patients, and so personally, I am not surprised if diet is not a popular choice, as this requires a lifestyle change, and the medication options generally do not.
 
I have since checked the endoscopic remission rate for those on PPI which was 75% (6/8).
 
6-food elimination diet was only considered if 2-food and 4-food elimination had been unsuccessful.
 
Endoscopies were completed 8-16 weeks following dietary changes.
 
Unfortunately, we do not have the data yet to monitor relapse rate post food reintroduction.

Christine Spray
Christine Spray
20 days ago

Thank you for your reply

Claire Leivers
Claire Leivers
19 days ago

Thank you for the poster – very informative. Can I ask how long you remain on each stage before advising the 4 or 6 food exclusion? Is the assessment to decide whether further restrictions are indicated informed by symptoms alone at each stage, or endoscopy?

Did you see no improvement or minimal improvement between each level of food restriction?

Sarah Khweir
Sarah Khweir
19 days ago
Reply to  Claire Leivers

Hello. Thanks for your message. Patients are on therapy for 8-12 weeks, but can be slightly longer due to endoscopy date. We change treatment based on endoscopy as symptoms are not indicative always of improvement in histology.
I think it is hard to answer the last question as we do not have a lot of data yet but 2-food elimination (or even 1-food) has shown to be successful so we do try to keep to the least number of exclusions as possible.