Department of Gastroenterology, Hospital Universitario de Caceres, 10004 Caceres, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, 28029 Madrid, Spain.
Nutrients. 2022 Apr 12;14(8):1588. doi: 10.3390/nu14081588.
The step-up empiric elimination diet, starting from one/two food groups of most local allergens remains the current gold standard for a dietary approach in eosinophilic esophagitis (EoE) patients. Milk, followed by wheat and egg, is the most frequent food that triggers EoE in pediatric and adult patients. Elimination diets, with restrictions over four food groups, may be limited to highly motivated patients, in which nutritional counseling is recommended. Malnourishment is uncommon in EoE patients and likely multifactorial (concomitant gastrointestinal eosinophilic disorders or IgE-mediated food allergies, feeding difficulties, abnormal feeding behavior). Avoidant/restrictive food intake disorder in EoE children on highly restrictive diets was lately described and may warrant specific psychological support. As for adults, quality of life may be impaired by symptom severity and dietary restrictions, aside from recently reported food impaction-related specific anxiety in up to 43% of patients. Severe symptoms, feeding dysfunction, and diet restrictions may negatively influence psychosocial adjustment for patients and their caregivers.
从最常见的本地过敏原的一种/两种食物组开始逐步进行经验性消除饮食，仍然是嗜酸性食管炎（EoE）患者饮食治疗的当前金标准。牛奶，其次是小麦和鸡蛋，是引发儿科和成年患者 EoE 的最常见食物。限制四种食物组的消除饮食可能仅限于高度积极的患者，推荐进行营养咨询。EoE 患者营养不良并不常见，且可能是多因素的（伴随胃肠道嗜酸性疾病或 IgE 介导的食物过敏、喂养困难、异常喂养行为）。最近描述了在高度限制饮食的 EoE 儿童中出现的回避/限制型食物摄入障碍，可能需要特定的心理支持。对于成年人，除了最近报道的高达 43%的患者中与食物嵌塞相关的特定焦虑外，生活质量可能因症状严重程度和饮食限制而受损。严重的症状、喂养功能障碍和饮食限制可能会对患者及其护理人员的社会心理调整产生负面影响。
