Consider Food Allergy Testing in Managing Eosinophilic Esophagitis

An integrated approach involving gastroenterologists, nutritionists, and pathologists is recommended.

Food antigens can induce esophageal remodeling with fibrosis, which can resolve with appropriate food antigen elimination. Addressing food allergens in the treatment of eosinophilic esophagitis (EoE) is recommended in a recent guideline (NEJM JW Gastroenterol Jun 7 2013). Although allergy testing is common practice for pediatric gastroenterologists, most adult gastroenterologists are relatively unfamiliar with the practice. The current review provides in-depth guidance, including:

Allergy testing for foods may be more useful in pediatric patients.
The negative predictive values (PVs) of tests for identifiable food allergies are generally higher than positive PVs.
Patients with EoE are often highly atopic and have polysensitization to both food…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors