Targeted Elimination Diet in EoE Patients Following Identification of Trigger Nutrients Using Confocal Laser Endomicroscopy

Using confocal laser endomicroscopy (CLE), gastrointestinal allergic reactions to certain foods in the duodenum will be evaluated on a cellular level. After that, a personalized exclusion diet will be followed based on the CLE results for 6 weeks, sham-controlled, in a cross-over fashion. Gastroscopy with esophageal biopsies will be repeated after each diet.

Inclusion Criteria:Eosinophilic Esophagitis, with peak eosinophil count of >15 eos/HPF and symptoms of dysphagia at least 2 days per weekPatients have had a trial of high-dose PPI for at least 8 weeks, with either documented non-response or intolerance to the medicationPatients aged between 18 and 70 years oldSigned written informed consentEosinophilic Esophagitis, with peak eosinophil count of >15 eos/HPF and symptoms of dysphagia at least 2 days per weekPatients have had a trial of high-dose PPI for at least 8 weeks, with either documented non-response or intolerance to the medicationPatients aged between 18 and 70 years oldSigned written informed consentExclusion criteria:IgE-mediated food anaphylaxis for 1 of the trigger nutrientsHistory of major gastrointestinal surgery complicating esophago-gastro-duodenoscopyGastro-esophageal reflux disease (GERD) Los Angeles grade C or DEsophageal strictures, too narrow to pass with a normal gastroscopeEndoscopic dilation in the esophagus in the 4 weeks prior to inclusionCeliac diseaseRecent use (within two weeks) of non-steroidal anti-inflammatory drugs (NSAIDs), systemic histamine-receptor antagonists, mast cell stabilizers, opioids.Proton pump inhibitors must be either stopped for at least 4 weeks, or continued on a stable dosage throughout the study period.Corticosteroids should be stopped for at least 4 weeks.Allergy to fluorescein, Xylocain or PropofolPregnant or lactating women