All research presented at ACG 2025 is strictly embargoed until 12:00 pm local Arizona Time, which aligns with Pacific Daylight Time (PDT)/3:00 pm ET on Sunday, October 26, 2025.
P0612 – Comparing Different Elimination Diets in the Treatment of Eosinophilic Esophagitis: A Systematic Review and Network Meta-Analysis
Sunday, October 26, 2025 | 3:30 PM – 7:00 PM PDT | Exhibit Hall
Author Insight from Usman Bin Hameed, MD
What’s new here and important for clinicians?
- We synthesized 7 studies (N=567) in a frequentist network meta-analysis comparing elemental diet, one-food elimination diet, four-food elimination diet, four-food plus amino acid formula, six-food elimination diet, and six-food plus amino acid formula for histologic remission in eosinophilic esophagitis (EoE).
- Four-food plus amino acid formula (FFED+AAF) ranked highest, elemental diet (ED) next, and six-food plus amino acid formula (SFED+AAF) lowest use this signal to guide practical first-line choices.
- In real-world care, prioritize adherence, nutrition, and feasibility: a targeted, step-up approach (FFED ± AAF) is a pragmatic default; reserve ED for select cases given palatability/cost.
- Implementation: dietitian-guided four-food elimination (FFED), consider amino acid formula (AAF) when intake/weight is at risk, and confirm remission histologically at ~6–12 weeks.
- If not in remission: escalate diet (e.g., FFED → FFED+AAF or expand triggers) or add topical steroids, then proceed to structured reintroduction to minimize long-term restriction.
What do patients need to know?
- Diet can heal the esophagus. Several food-elimination plans can reduce the inflammation that causes trouble swallowing and food sticking in eosinophilic esophagitis.
- Simple can be powerful. A four-food elimination plan with an amino acid formula often balances effectiveness with day-to-day practicality and is easier for many people to follow than very strict plans.
- One size doesn’t fit all. The elemental diet can work, but many people find it hard to maintain and expensive. The best plan is the one you can stick with while staying well-nourished.
- Expect a clear roadmap. You’ll start with an elimination phase, then have a follow-up endoscopy with biopsies to make sure the inflammation is truly better. After that, foods are re-introduced step by step to find your personal triggers.
- You won’t do this alone. Work with your GI team and a dietitian to choose a plan that fits your life, protects your nutrition and weight, and keeps you feeling well at home, work, and school.
Author Contact
Usman Bin Hameed, MD
Corewell Health William Beaumont University Hospital
Royal Oak, MI
usman.binhameed@corewellhealth.org
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