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Gastroenterology 1995 Nov;109(5):1503-12

Eosinophilic esophagitis attributed to gastroesophageal reflux: improvement with

an

amino acid-based formula.

KJ, Lazenby AJ, Rowe PC, Yardley JH, Perman JA, Sampson HA

Division of Pediatric Gastroenterology/Nutrition, s Hopkins University

School of

Medicine, Baltimore, land, USA.

BACKGROUND & AIMS: Treatment for gastroesophageal reflux may be ineffective in

patients with an eosinophilic infiltration of the esophagus. The aim of this

study

was to investigate whether unremitting symptoms of gastroesophageal reflux and

biopsy

abnormalities of the esophagus may be associated with the ingestion of certain

foods.

METHODS: Ten children previously diagnosed with gastroesophageal reflux by

standard

testing with long-standing symptoms (median, 34.3 months; range, 6-78 months)

despite

standard antireflux therapies, including Nissen fundoplication in 6 patients,

were

fed the elemental formulas Neocate or Neocate-1-Plus (Scientific Hospital

Supplies

Inc., Gaithersburg, MD) for a minimum of 6 weeks. Each child had repeat

endoscopy

followed by open food challenges. RESULTS: While receiving the formulas,

patients had

either resolution (n = 8) or improvement (n = 2) of symptoms. On follow-up

esophageal

biopsy, the maximal intraepithelial eosinophil counts decreased significantly

before

(median, 41; range, 15-100) to after (median, 0.5; range, 0-22) the formula

trial (P

= 0.005). Other reactive epithelial changes of the esophageal mucosa also

improved

significantly. All patients redeveloped their previous symptoms on open food

challenges. CONCLUSIONS: Chronic gastrointestinal symptoms and histological

changes

of the esophagus unresponsive to standard treatments for gastroesophageal reflux

were

improved by the use of elemental formulas. Symptoms recurred when specific

dietary

proteins were reintroduced during open food challenges. The mechanism of these

observations is unknown.

Publication Types:

Clinical trial

PMID: 7557132, UI: 96036339

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In a message dated 7/19/99 12:21:45 PM Pacific Daylight Time,

Lynda@... writes:

<< 1; range, 15-100) to after (median, 0.5; range, 0-22) the formula trial (P

= 0.005). Other reactive epithelial changes of the esophageal mucosa also

improved

significantly. All patients redeveloped their previous symptoms on open food

challenges. CONCLUSIONS: Chronic gastrointestinal symptoms and histological

changes

of the esophagus unresponsive to standard treatments for gastroesophageal

reflux were

improved by the use of elemental formulas. Symptoms recurred when specific

dietary

proteins were reintroduced during open food challenges. The mechanism of

these

observations is unknown. >>

dose this mean they need to find what foods the kids are alergic to, or

that they need to stay on the neocate formula?

Cathy

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In a message dated 7/19/99 12:21:45 PM Pacific Daylight Time,

Lynda@... writes:

<< 1; range, 15-100) to after (median, 0.5; range, 0-22) the formula trial (P

= 0.005). Other reactive epithelial changes of the esophageal mucosa also

improved

significantly. All patients redeveloped their previous symptoms on open food

challenges. CONCLUSIONS: Chronic gastrointestinal symptoms and histological

changes

of the esophagus unresponsive to standard treatments for gastroesophageal

reflux were

improved by the use of elemental formulas. Symptoms recurred when specific

dietary

proteins were reintroduced during open food challenges. The mechanism of

these

observations is unknown. >>

dose this mean they need to find what foods the kids are alergic to, or

that they need to stay on the neocate formula?

Cathy

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