We know that milk is the most common trigger for EoE. Multiple studies, including those looking at the 6 Food Elimination Diet and 4 Food Elimination diet, clearly demonstrates this. In these studies cow’s milk was strictly removed from the diet including yogurt, cheese, pizza, and also in baked products such as bread, muffins, and cakes.
For patients with IgE mediated allergies, e.g. who have experienced hives, with cow’s milk, some after discussion with their doctor may be able to eat these baked milk products without symptoms. The question is whether those who have cow’s milk triggered eosinophilic esophagitis can do the same. A small retrospective review in 2013 looked at this question.
The study included 15 patients (ages 6 – 17 years) with eosinophilic esophagitis with milk as a trigger. They were labelled as milk-allergic if they had 1) remission of the esophageal eosinophilia with dairy restriction, 2) return of esophageal eosinophilia with dairy reintroduction, after previously being healed, or both. Based on review of the medical records, they all were determined to havehad baekd milk products 3 to 4 times per week for at least 6 weeks before a follow-up endoscopy.
For this study baked milk referred to bread, muffins, cakes and brownies, but not baked cheese e.g. pizza.
Study Findings
- 11 of 15 (73%) patients remained in remission with baked milk in the diet
- 3 of 4 patients who had increased esophageal eosinophilia also reported mild symptoms (abdominal pain or difficulty swallowing)
This study indicates that some EoE patients may be able to tolerate baked milk in their diet, even if whole milk is a trigger. Caveats about this study is that they did not assess if baked cheese is tolerated.
Also keep in mind that this was a retrospective study looking at small numbers of patients, so it should not be relied upon to give an accurate prediction about percentage of EoE patients who may be able to tolerate baked milk. Overall though, does indicate that some patients may be able to eat milk in these forms.
Remember always talk with your health care provider before making any changes to your treatment regimen.