Abstract
Rationale Eosinophilic Esophagitis (EE) is a recently described disorder identified in patients with symptoms suggestive of gastroesophgeal reflux disease but unresponsive to conventional therapies. The hallmark pathologic finding is eosinophilia in the esophagus (>15/HPF) with normal pathology of the stomach and duodenum. Therapies have included corticosteroids, elemental diet, and diet restriction. We report our experience with prick and patch skin testing and food elimination diets in 115 patients diagnosed with Eosinophilic Esophagitis. Methods Patients were diagnosed with EE by biopsy and referred from gastroenterology. Food antigens were identified prospectively by prick skin test and patch skin testing. Repeat biopsy was obtained after 4 to 8 weeks of restricted diet. Demographics, atopic tendencies, and identified food antigens were identified. Results 115 patients diagnosed with EE were evaluated with skin and patch testing. 87/115 (75.6.9%) responded to diet elimination of identified food antigens and had resolution of their EE with normal biopsy results (<10 eosinophils/HPF). 17/115 (16.3%) were non-responders without reduction in eosinophils. Egg and milk were identified most frequently with prick testing while corn and wheat was identified most frequently with patch testing. Conclusions The majority of patients with EE can be successfully treated by eliminating suspected foods identified by a combination of prick and patch skin testing.
Published Version
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