Eosinophilic esophagitis (EoE) is an allergic inflammatory condition of the esophagus and is a relatively newly recognized disease in Europe. During active eosinophilic esophagitis (EoE), which is associated with a reduction of quality of life for the patient, the barrier function of the esophageal mucosa is impaired. Therefore, it is important to further investigate this esophageal barrier function during disease.
This is the first time a study indicates that by exclusively using an elemental diet, which excludes dietary allergens, the condition is in remission but also restores the esophageal mucosal integrity. An elemental diet is for example an amino acid-based formula in which cow’s milk proteins are replaced by amino acids, which enables cow’s milk allergic patients to get the necessary nutrients without allergic symptoms. In this prospective study 17 adult EoE patients and 8 healthy controls were included.
The study, as published in The American Journal of Gastroenterology, is an important step in the journey to better understand EoE and specifically the function of the esophageal mucosal barrier in EoE.
The study concluded that the complete absence of food allergens, by using a four week elemental diet, may restore esophageal mucosal integrity. This suggests that the esophageal mucosal integrity changes are at least partly secondary to inflammation and/or allergen exposure. In addition, the data suggest that duodenal mucosal integrity is not affected in EoE, suggesting integrity impairment of the mucosal barrier is a local phenomenon.