Specific food elimination diet is a dietary management approach based upon results of food allergy testing with combination of skin prick, IgE blood testing or atopy patch testing. An allergist familiar with this disease would need to complete testing and discuss results with the patient about removal of foods from the diet. Keep in mind that atopy patch testing to foods is not performed by most allergy offices. Furthermore, no results from any allergy tests can guarantee healing in EoE.
Foods that are recommended to be restricted should generally be carefully avoided because even small amounts as a secondary ingredient may be enough to results in persistent substantial inflammation of the esophagus. The most common foods are detected on allergy testing are milk, egg, wheat, soy, peanuts, treenuts, chicken, beef, and corn. It is important to note that milk is probably one of the most common foods to trigger EoE, however, unfortunately it appears that even when allergy tests are all negative to cow’s milk protein, it frequently still can be a common cause for EoE. Therefore, your physician may recommend avoidance of milk (or other foods) even though testing was negative.
Specific food elimination diets can be difficult to adhere to, especially if a major common allergen is involved. So a dietitian or nutritionist who is familiar with food allergies can be an invaluable resource to help guide these diets. A dietitian can assess the nutritional status, provide dietary suggestions, and ensure adequate nutrition is maintained while on the diet. Furthermore, familiarity with reading ingredient labels is essential for successfully maintaining these diets.