First AD

Second AD

A 25-year-old man with eosinophilic esophagitis (EoE) that is partially responsive to topical corticosteroids is interested in dietary treatment. He has read about the six-food elimination diet and inquires about this option. 

The six-food elimination, which consists of milk, wheat, eggs, soy, nuts, and seafood, is an effective treatment option for EoE. However, adherence can be challenging. Studies in children and adults have demonstrated that the two most common allergens leading to EoE are wheat and milk. More than 50% of EoE patients will improve with elimination of only these two type of foods. Eggs, soy, nuts are the next most common triggers, with seafood being the least likely.

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Allergy

Gastroenterology

For a young man with eosinophilic esophagitis, which potential allergen is most likely the cause of his symptoms? 

Which of the “Six Foods” Would You Eliminate First?