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Elimination Diets for Food Reactions

An abundance of diet therapies are proposed to treat chronic intestinal disorders such as the irritable bowel syndrome (IBS) and eosinophilic esophagitis (EoE). These commonly either eliminate or restrict specific foods and/or food components, based on the principle that even trace amounts induce an immune reaction (e.g., elimination diets for EoE), or, in the case of restrictive diets, that individuals have a threshold level of tolerance below which symptom control will be induced. The low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet for IBS is one example of a restrictive diet based on sound rationale, robust efficacy data, comprehensive food composition information that is publicly available in a user-friendly form, and, increasingly, longitudinal data to demonstrate the long-term benefits. To optimize patient outcomes, health care professionals must be aware of the risks, benefits, and clinical indications for the use of diet therapies proposed to treat chronic intestinal disorders.