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Avoidant/Restrictive Food Intake Disorder in Diet-treated Children With Eosinophilic Esophagitis

Robson, Jacob*; Laborda, Trevor*; Fitzgerald, Susan; Andersen, Joseph*; Peterson, Kathryn; O’Gorman, Molly*; Guthery, Stephen*; Bennett-Murphy, Laura§

Journal of Pediatric Gastroenterology and Nutrition: July 2019 - Volume 69 - Issue 1 - p 57–60
doi: 10.1097/MPG.0000000000002323
Short Communication: Gastroenterology: Eosinophilic GI Disorders
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ABSTRACT Eosinophilic esophagitis (EoE) is an inflammatory condition of the esophagus with rising incidence in children. Owed to potential adverse effects and high costs of EoE medications, strict elimination diets are often employed as a mainstay of long-term EoE therapy in children. Currently, there are no effective tests to pinpoint food protein triggers in children with EoE. Therefore, EoE elimination diets are often broad (including milk, soy, wheat, egg, fish/shellfish, and nuts) and can greatly alter a child's baseline eating habits. Herein, we describe 2 cases of avoidant/restrictive food intake disorder (ARFID) in children with remitted EoE maintained on an elimination diet. We also present comorbidity data on ARFID and diet-treated EoE from our pediatric EoE clinic. This is the first report of disordered eating associated with EoE therapy. As EoE is becoming more common, close monitoring of intake and growth in patients treated with elimination diets will be key.

*Food Allergy and Eosinophilic Gastrointestinal Disorders Clinic, Division of Gastroenterology, Department of Pediatrics, University of Utah, Primary Children's Hospital

Food Allergy and Eosinophilic Gastrointestinal Disorders Clinic, Primary Children's Hospital, Intermountain Healthcare

Division of Gastroenterology, Department of Internal Medicine, University of Utah

§Food Allergy and Eosinophilic Gastrointestinal Disorders Clinic, Division of Pediatric Psychiatry and Behavioral Health, Department of Pediatrics, University of Utah, Primary Children's Hospital, Salt Lake City, UT.

Address correspondence and reprint requests to Jacob Robson, MD, MS, Division of Gastroenterology, Department of Pediatrics, University of Utah, Primary Children's Hospital, 81 North Mario Capecchi Dr, Salt Lake City, UT 84113 (e-mail: Jacob.robson@hsc.utah.edu).

Received 6 September, 2018

Accepted 5 February, 2019

The authors report no conflicts of interest.

© 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,