Malnutrition in Eosinophilic Gastrointestinal Disorders

Votto, Martina; Filippo, Maria De; Olivero, Francesca; Raffaele, Alessandro; Cereda, Emanuele; Amici, Mara De; Testa, Giorgia; Marseglia, Gian Luigi

doi:10.3390/nu13010128

Cited by 19 publications

(34 citation statements)

References 66 publications

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“…and post-intervention. 5 Statistically, there was no difference in BMI values and prevalence of obese patients. Obesity is a global health problem associated with many chronic diseases.…”

Section: F I G U R E 1 (A)vitamin D Levels Of Enrolled Patients (B) Bmi Values Of Enrolled Patientsmentioning

confidence: 87%

Nutritional status in eosinophilic gastrointestinal disorders: A pediatric case‐control study

Votto

Bonitatibus

Filippo

et al. 2022

Pediatric Allergy Immunology

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Primary eosinophilic gastrointestinal disorders (EGIDs) are emerging inflammatory diseases of unknown etiology which may involve any part of the gastrointestinal (GI) tract and lead to a pathological eosinophilic mucosal infiltration. 1,2 Although their pathogenic mechanisms are mostly unknown, EGIDs seem to be commonly associated with atopy. 3 Based on the GI tract involved, EGIDs are classified in eosinophilic esophagitis (EoE) and non-esophageal EGIDs. EoE is currently considered one of the major causes of upper gastrointestinal morbidity, with a significant burden on patients, caregivers, and the healthcare system. 4 Children with non-esophageal EGIDs may present non-specific GI symptoms, mainly depending on depth (mucosal, muscular, and serosal forms) and the extension of the inflammatory process. 1 On the contrary, patients with EoE generally develop symptoms due to esophageal dysfunction and inflammation. Although the prevalence is still unknown, several studies reported that EGIDs may be associated with malnutrition, including undernutrition, inadequate intake of vitamins and/or minerals, and overweight/obesity. 4 Vitamin D deficiency has also been reported in

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“…and post-intervention. 5 Statistically, there was no difference in BMI values and prevalence of obese patients. Obesity is a global health problem associated with many chronic diseases.…”

Section: F I G U R E 1 (A)vitamin D Levels Of Enrolled Patients (B) Bmi Values Of Enrolled Patientsmentioning

confidence: 87%

Nutritional status in eosinophilic gastrointestinal disorders: A pediatric case‐control study

Votto

Bonitatibus

Filippo

et al. 2022

Pediatric Allergy Immunology

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“…At baseline, patients with active EoE are generally not malnourished ( 31 ). However, toddlers and young children may present growth failure and feeding issues that are not a contraindication for an elimination diet after a comprehensive assessment of the nutritional status ( 32 ).…”

Section: Diet Therapymentioning

confidence: 99%

“…Firstly, children with EoE generally present symptoms that may limit the adequate nutritional intake, such as recurrent vomiting and regurgitation, abdominal pain, lack of appetite, low volume and/or poor variety food intake, grazing, and spitting food out ( 31 ). Patients with chronic esophageal inflammation develop compensative feeding habits (i.e., drinking a lot during meals, eating slowly, chewing carefully, cutting food into small pieces, lubricating foods with sauces or liquids), or avoiding some foods (meat, crusty bread, pills) ( 20 ).…”

Section: Nutritional Considerations and Patient Educationmentioning

confidence: 99%

“…Thirdly, the coexistence of multiple (IgE and non-IgE mediated) food allergies might be a further reason for failure to thrive and undernutrition. On the other hand, long-term restrictive FEDs may compromise adequate micronutrient intake, although they do not appear to worsen child growth or BMI ( 31 , 61 ). For these reasons, in children treated with 1- or 2-FED, regular clinical follow-up is recommended to identify early potential nutritional deficiency and growth impairment ( Table 3 ).…”

Section: Nutritional Considerations and Patient Educationmentioning

confidence: 99%

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Diet Therapy in Eosinophilic Esophagitis. Focus on a Personalized Approach

et al. 2022

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Eosinophilic esophagitis (EoE) is a chronic allergic disease defined by a marked eosinophilic inflammation and symptoms of esophageal dysfunction. EoE is a heterogeneous disease and severely impacts the quality of life of affected patients. The current therapeutic management of EoE is based on two cornerstones: medication and diet therapy, both effective but limited by several critical issues. The choice of one or the other therapy might depend on the different disease phenotypes (allergic vs. non-allergic, inflammatory vs. fibro-stenotic), patient's age (adult vs. childhood-onset), food habits, patient/family preference, and familiar financial resource. Diet therapy is a successful treatment but limited by low patient adherence, the need for several endoscopies, food restrictions, psychosocial impact, and potential nutritional deficiencies. All these limitations could be effectively overcome with multidisciplinary and personalized management. This review summarizes the most recent evidence on the dietary elimination approaches and will provide a practical guide to clinicians in managing and implementing dietary therapy for patients with EoE.

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“…According to the recent guidelines [ 1 ], an ED should only be used for 4 weeks as a last resort in highly refractory cases followed by an EGD to show resolution, and the fast reintroduction of foods should be recommended [ 121 ]. In fact, while ED can be useful and has an efficacy rate of at least 90% in children affected by multiple food allergies, growth deficiency, refractory disease, and highly unbalanced diets, in older children it almost always requires nasogastric tube feeding due to its unpleasant taste and it can mask a feeding disorder, especially in malnourished patients [ 125 – 127 ].…”

Section: Therapymentioning

confidence: 99%

Pediatric eosinophilic esophagitis: a review for the clinician

et al. 2021

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Eosinophilic esophagitis (EoE) is a chronic clinical-pathologic disease characterized by eosinophilic infiltration of the esophageal epithelium with esophageal dysfunction symptoms.EoE can occur at any age and has different clinical manifestations depending on the age onset.To date, esophago-gastroduodenal endoscopy (EGD) with biopsy is the gold-standard for EoE diagnosis.According to the recent consensus guidelines, proton pump inhibitors, corticosteroids and elimination diets could be a first-line therapy option. The aim of the treatment is clinical and histological remission for preventing long-lasting untreatable fibrosis.A multidisciplinary approach (allergist, gastroenterology, dietitian, and pathologist) is recommended for managing patients affected by EoE, given the complexity of its treatment.This review will provide a practical guide to assist pediatricians treating children with EoE.Moreover, it highlights the unmet needs in diagnosis and treatment that require urgent attention from the scientific community in the aim of improving the management of patients with EoE.

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Malnutrition in Eosinophilic Gastrointestinal Disorders

Cited by 19 publications

References 66 publications

Nutritional status in eosinophilic gastrointestinal disorders: A pediatric case‐control study

Nutritional status in eosinophilic gastrointestinal disorders: A pediatric case‐control study

Diet Therapy in Eosinophilic Esophagitis. Focus on a Personalized Approach

Pediatric eosinophilic esophagitis: a review for the clinician

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