Kagalwalla et al used a six food elimination diet to evaluate patients with eosinophilic esophagitis. The same diet can be used to evaluate patients with other suspected food allergies. The authors are from Northwestern University and Children’s Memorial Hospital in Chicago.


Foods included in elimination diet:

(1) cow milk or cow milk protein

(2) soy

(3) egg

(4) wheat and other gluten containing items

(5) peanut and tree nuts

(6) fish


All other foods were allowed.


The diet was maintained for 6 weeks. If improvement was noted then an attempt was made to identify the specific problem food.


Reasons for lack of improvement:

(1) The diagnosis is wrong (not food allergy).

(2) The target allergen was not eliminated.

(3) The patient was unaware of allergen in a food.

(4) The patient was noncompliant.


Reasons for a false positive (improvement while on diet):

(1) The actual underlying condition improved on its own during the 6 weeks.


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