Madison Jill M, Bhardwaj Vrinda, Braskett Melinda
Division of Clinical Immunology & Allergy, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Curr Gastroenterol Rep. 2020 Mar 28;22(5):25. doi: 10.1007/s11894-020-00758-2.
This review presents the available data regarding efficacy of nutritional therapy, highlighting clinical decision points and a strategy for reintroduction of foods following an elemental diet for treatment of eosinophilic gastrointestinal disorders.
Elemental and empiric elimination diets are highly effective treatments for eosinophilic gastrointestinal diseases. Standardization in the reintroduction phase, after utilizing the diet for disease remission, is lacking. Clinicians are confronted with multiple challenges regarding the best practice for food reintroduction and identification of potential dietary triggers including order of foods being challenged and duration between endoscopic procedures. Individualization is required for preference and adherence to optimize quality of life and treatment success for this burdensome and life altering immune driven gastrointestinal disorder. Age specific concerns for children, teenagers, and adults should be assessed using a patient centric approach.
本综述介绍了有关营养治疗疗效的现有数据,重点阐述了临床决策要点以及在采用要素饮食治疗嗜酸性胃肠道疾病后重新引入食物的策略。
要素饮食和经验性排除饮食是治疗嗜酸性胃肠道疾病的高效疗法。在利用饮食实现疾病缓解后的重新引入阶段缺乏标准化。临床医生在食物重新引入的最佳实践以及识别潜在饮食触发因素(包括受挑战食物的顺序和内镜检查之间的间隔时间)方面面临多重挑战。需要因人而异以优化偏好和依从性,从而改善这种由免疫驱动的、负担沉重且改变生活的胃肠道疾病的生活质量并提高治疗成功率。应采用以患者为中心的方法评估儿童、青少年和成人的特定年龄相关问题。