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Elimination Diet Targets Esophagus Inflammation

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inflammation of the esophagus may respond to elimination diet Hemera/Thinkstock

Whenever digestive problems involve the throat, esophagus or upper chest, you might experience heartburn, difficulty in swallowing or that “food stuck in the throat” sensation.

You might associate such symptoms with children who have food allergies, but when these symptoms are seen in adults, there can be a number of causes. Doctors are finding that with adults, too, they can be food-related.

This brings into play a condition called eosinophilic esophagitis, or EoE, because it is increasingly behind cases of throat and chest discomfort in adults.

In simplest terms, EoE occurs when the esophagus becomes inflamed from an increased number of eosinophils, a type of white blood cell. These cells are provoked into production by allergens, drugs, parasites and other means.

If you zero in on food allergies as a possible cause of EoE, then there’s good news from the American Gastroenterological Association.

A recent article in Gastroenterology, the AGA’s official journal, reviewed the success of a six-food elimination diet in adult patients with EoE. In fact, identifying food triggers could become a therapeutic alternative to corticosteroids, the article said.

Dr. Nirmala Gonsalves of Northwestern University, lead author of the study on the six-food elimination diet, said it could help identify food triggers when the patient has no history of food allergy or intolerance.

“By first eliminating, then systematically reintroducing foods in our adult patients, we were able to identify the specific food triggers that caused their symptoms, such as heartburn, chest pain and difficulty swallowing, or the sensation of food being stuck in their throat,” said Gonsalves.

She added that by undergoing the elimination diet, adult EoE patients would be in a position to receive better information for tailoring their individual diet and managing their symptoms for the long-term.

The elimination diet studied at Northwestern involved six common culprits -- milk, soy, egg, wheat, peanuts/tree nuts and shellfish/fish.

When the regimen was complete, participants showed an improvement in symptoms and a reduction in esophageal tissue damage associated with EoE. Also, 78 percent of participants saw eosinophil cell counts in their esophagus go down by half.

Cases of EoE generally appear to be on the rise. The Mayo Clinic reports that it was among the first U.S. medical centers to publish research on incidence, and cited a more than tenfold increase in EoE cases in the last 30 years.

The Mayo’s patient information page on EoE notes that treatment involves one or more of these three strategies:

- Dietary therapy, when the inflammation of the esophagus appears to be food-related. Doctors might perform a skin-prick test or prescribe an elimination diet.

- Medications, usually steroids to decrease white blood cells in the esophagus, lessen inflammation and give the esophagus a chance to heal. The steroids that are prescribed are typically not the kind that produce unwanted side effects.

- Experimental therapies, including asthma medications and acid-blocking medications. Mayo is among the research centers now looking at such experimental treatments.


“Food Elimination Diet Identifies Causes of Difficulty Swallowing and Swelling of the Throat.” American Gastroenterological Association press release. Web. 8 October 2012.

“Eosinophilic Esophagitis.” MayoClinic.com. Web. 8 October 2012.

Reviewed October 9, 2012
by Michele Blacksberg RN
Edited by Jody Smith

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.



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