Reed CC, et al. - The long-term outcomes of food elimination diets for treatment of adults with eosinophilic oesophagitis (EoE) were evaluated in this study. Maintenance dietary therapy produced durable long-term symptomatic, endoscopic and histological disease control among EoE patients responding to a food elimination diet and remaining adherent. These long-term data confirmed that in selected adults with EoE, a food elimination diet was an effective maintenance treatment option.

• The authors performed a retrospective cohort study at their centre analysing all EoE patients receiving a food elimination diet without concomitant steroids.
• They abstracted baseline data using standardised collection forms.
• They collected follow-up data from a mean 24.9-month period for patients with a histological response to a food elimination diet during and after food reintroduction.
• Symptomatic, endoscopic and histological responses were the main outcomes.

• 18 patients received a 6-food food elimination diet, 32 patients received targeted diet, and 2 patients received a 6-food food elimination diet with targeted elimination among 52 patients.
• There were 21 (40%) patients with an initial histological response.
• After treatment, responders reported less dysphagia (95% baseline vs 11%; P = .001) and at the end of follow-up (95% baseline vs 33%; P = .008).
• At the same time points, significant and durable endoscopic improvements were recorded: Endoscopic reference score: 3.2 vs 0.7; P = .001; and 3.2 vs 1.7; P = .06.
• After the most restrictive diet, histological findings improved in responders (49.8 vs 4.1 eosinophils per high-power field; P = .001) and remained suppressed in the 10 initial responders maintaining compliance at the end of follow-up (5.2 eosinophils per high-power field).