Allergy testing accurately identifies the food triggers in eosinophilic esophagitis (EoE).
False: Eosinophilic (ee-uh-sin-uh-fil-ik) esophagitis (EoE) is an allergic condition that causes inflammation of the esophagus. The esophagus is the tube that sends food from the throat to the stomach.
Research suggests that the leading cause of EoE is an allergy or a sensitivity to particular proteins found in foods. In fact, up to 50% of patients show evidence of IgE sensitization to multiple foods. Foods such as dairy products, egg, soy and wheat are main causes of EoE. If you are diagnosed with specific food allergies after prick skin testing and patch testing, your doctor may remove specific foods from your diet. In some individuals this helps control their EoE.
However, the results of allergy testing alone do not always accurately identify the food triggers in EoE. Skin prick testing predicted 13% of causative foods in adults and children and combination prick and patch testing predicted 44% of causative foods in children. Food patch testing has not been standardized or validated in EoE. However, positive food patch tests do occur in 30 to 95% of children and adults with EoE.
Gonsalves N, Yang GY, Doerfler B, Ritz S, Ditto AM, Hirano I. Elimination diet effectively treats eosinophilic esophagitis in adults; food reintroduction identifies causative factors. Gastroenterology. 2012 Jun;142(7):1451-9 e1; quiz e14-5. PubMed PMID: 22391333. 2012.
Spergel JM, Brown-Whitehorn TF, Cianferoni A, Shuker M, Wang ML, Verma R, et al. Identification of causative foods in children with eosinophilic esophagitis treated with an elimination diet. The Journal of Allergy and Clinical Immunology. 2012 Aug;130(2):461-7 e5. PubMed PMID: 22743304. Epub 2012/06/30. eng. 2012.
Liacouras CA, Spergel JM, Ruchelli E, Verma R, Mascarenhas M, Semeao E, et al. Eosinophilic esophagitis: a 10-year experience in 381 children. Clinical Gastroenterology and Hepatology: the official clinical practice journal of the American Gastroenterological Association. 2005 Dec;3(12):1198-206. PubMed PMID: 16361045. Epub 2005/12/20. eng. 2005. (III).
Peterson KA, Byrne KR, Vinson LA, Ying J, Boynton KK, Fang JC, et al. Elemental Diet Induces Histologic Response in Adult Eosinophilic Esophagitis. The American Journal of Gastroenterology. 2013 Feb 5. PubMed PMID: 23381017. 2013.
Kagalwalla AF, Sentongo TA, Ritz S, Hess T, Nelson SP, Emerick KM, et al. Effect of six-food elimination diet on clinical and histologic outcomes in eosinophilic esophagitis. Clinical Gastroenterology and Hepatology: the official clinical practice journal of the American Gastroenterological Association. 2006 Sep;4(9):1097-102. PubMed PMID: 16860614. Epub 2006/07/25.
Liacouras CA, Furuta GT, Hirano I, Atkins D, Attwood SE, Bonis PA, Burks AW, Chehade M, Collins MH, Dellon ES, Dohil R, Falk GW, Gonsalves N, Gupta SK, Katzka DA, Lucendo AJ, Markowitz JE, Noel RJ, Odze RD, Putnam PE, Richter JE, Romero Y, Ruchelli E, Sampson HA, Schoepfer A, Shaheen NJ, Sicherer SH, Spechler S, Spergel JM, Straumann A, Wershil BK, Rothenberg ME, Aceves SS. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011 Jul;128(1):3-20.e6; quiz 21-2.