Tolerability and safety of a new elimination diet for pediatric eosinophilic gastritis and duodenitis.

Elimination diet (ED) Eosinophilic duodenitis (EoD) Eosinophilic gastritis (EoG) Eosinophilic gastrointestinal disorders (EGID, EGIDs) Non-IgE-mediated gastrointestinal food allergy

Journal

Allergology international : official journal of the Japanese Society of Allergology
ISSN: 1440-1592
Titre abrégé: Allergol Int
Pays: England
ID NLM: 9616296

Informations de publication

Date de publication:
Apr 2023
Historique:
received: 17 05 2022
revised: 22 10 2022
accepted: 23 10 2022
medline: 4 4 2023
pubmed: 23 11 2022
entrez: 22 11 2022
Statut: ppublish

Résumé

Non-esophageal eosinophilic gastrointestinal disorders (non-EoE EGIDs) are chronic inflammatory disorders with massive infiltration of eosinophils into the gastrointestinal tract. Food elimination diets are potentially effective treatments. But the existing dietary therapies have various weak points. We developed a new regimen to compensate for the shortcomings of the elemental diet and 6-food elimination diet. The new regimen consists of an amino-acid-based formula, potatoes, vegetables, fruits and restricted seasonings. We named it the "Rainbow Elimination Diet (ED)." The aims of this study were to evaluate the tolerability and safety of this diet. A retrospective medical record examination was conducted at the National Center for Child Health and Development covering the period from January 2010 through December 2018. The medical records of patients (age 2-17 y) with histologically diagnosed non-EoE EGIDs were reviewed. The tolerability, nutritional intake, symptoms, and blood test findings were evaluated. Nineteen patients were offered several kinds of food-elimination diets. Seven patients (eosinophilic gastritis: 5; gastroenteritis: 1; duodenitis: 1) were treated with Rainbow ED. Six patients were compliant with this diet. The median duration of the diet induction phase was 15 days (range 14-30). All 5 patients who had had symptoms just before the induction phase became symptom-free. The body weight decreased in 5 patients (median -0.6 kg), probably because the serum protein increased, resulting in reduced edema. All 5 patients with hypoproteinemia had elevated serum albumin (median 2.9-3.5 g/dL). The ingested nutritional elements were calculated, and most of them were sufficient, except for fat and selenium. The Rainbow ED was well-tolerated and safe for pediatric non-EoE EGIDs.

Sections du résumé

BACKGROUND BACKGROUND
Non-esophageal eosinophilic gastrointestinal disorders (non-EoE EGIDs) are chronic inflammatory disorders with massive infiltration of eosinophils into the gastrointestinal tract. Food elimination diets are potentially effective treatments. But the existing dietary therapies have various weak points. We developed a new regimen to compensate for the shortcomings of the elemental diet and 6-food elimination diet. The new regimen consists of an amino-acid-based formula, potatoes, vegetables, fruits and restricted seasonings. We named it the "Rainbow Elimination Diet (ED)." The aims of this study were to evaluate the tolerability and safety of this diet.
METHODS METHODS
A retrospective medical record examination was conducted at the National Center for Child Health and Development covering the period from January 2010 through December 2018. The medical records of patients (age 2-17 y) with histologically diagnosed non-EoE EGIDs were reviewed. The tolerability, nutritional intake, symptoms, and blood test findings were evaluated.
RESULTS RESULTS
Nineteen patients were offered several kinds of food-elimination diets. Seven patients (eosinophilic gastritis: 5; gastroenteritis: 1; duodenitis: 1) were treated with Rainbow ED. Six patients were compliant with this diet. The median duration of the diet induction phase was 15 days (range 14-30). All 5 patients who had had symptoms just before the induction phase became symptom-free. The body weight decreased in 5 patients (median -0.6 kg), probably because the serum protein increased, resulting in reduced edema. All 5 patients with hypoproteinemia had elevated serum albumin (median 2.9-3.5 g/dL). The ingested nutritional elements were calculated, and most of them were sufficient, except for fat and selenium.
CONCLUSIONS CONCLUSIONS
The Rainbow ED was well-tolerated and safe for pediatric non-EoE EGIDs.

Identifiants

pubmed: 36414511
pii: S1323-8930(22)00126-5
doi: 10.1016/j.alit.2022.11.001
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

306-315

Informations de copyright

Copyright © 2022 Japanese Society of Allergology. Published by Elsevier B.V. All rights reserved.

Auteurs

Saori Nagashima (S)

Division of Eosinophilic Gastrointestinal Disorders, National Research Institute for Child Health and Development, Tokyo, Japan.

Mayu Yamamoto (M)

Division of Eosinophilic Gastrointestinal Disorders, National Research Institute for Child Health and Development, Tokyo, Japan.

Yusuke Inuzuka (Y)

Allergy Center, National Center for Child Health and Development, Tokyo, Japan.

Makoto Irahara (M)

Allergy Center, National Center for Child Health and Development, Tokyo, Japan.

Yumiko Miyaji (Y)

Allergy Center, National Center for Child Health and Development, Tokyo, Japan.

Hiromi Tadaki (H)

Department of Pediatrics, National Hospital Organization Yokohama Medical Center, Kanagawa, Japan.

Shuichi Ito (S)

Department of Pediatrics, Yokohama City University, Graduate School of Medicine, Kanagawa, Japan.

Shizuka Masuda (S)

Department of Nutrition, National Center for Child Health and Development, Tokyo, Japan.

Yoshiyuki Ito (Y)

Department of Nutrition, National Center for Child Health and Development, Tokyo, Japan.

Yuri Saito (Y)

Department of Nutrition, National Center for Child Health and Development, Tokyo, Japan.

Saeko Kobayashi (S)

Department of Nutrition, National Center for Child Health and Development, Tokyo, Japan.

Hideaki Morita (H)

Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, Tokyo, Japan.

Takako Yoshioka (T)

Department of Pathology, National Center for Child Health and Development, Tokyo, Japan.

Hirotaka Shimizu (H)

Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan.

Katsuhiro Arai (K)

Allergy Center, National Center for Child Health and Development, Tokyo, Japan; Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan.

Yukihiro Ohya (Y)

Allergy Center, National Center for Child Health and Development, Tokyo, Japan.

Hirohisa Saito (H)

Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, Tokyo, Japan.

Kenji Matsumoto (K)

Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, Tokyo, Japan. Electronic address: matsumoto-k@ncchd.go.jp.

Ichiro Nomura (I)

Division of Eosinophilic Gastrointestinal Disorders, National Research Institute for Child Health and Development, Tokyo, Japan; Allergy Center, National Center for Child Health and Development, Tokyo, Japan. Electronic address: nomura-i@ncchd.go.jp.

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Classifications MeSH