This diet involves removing the six most common foods that have been seen in allergic diseases, that is milk, egg, wheat, soy, peanuts/tree nuts, and seafood (fish/shellfish).
This was first proven useful in children but more recent studies in adults show good success rates also. In one study it appeared that rice and corn might be additional foods requiring elimination in some stubborn cases. If this treatment is used, it is done when a person is NOT taking medication, or we can’t tell what is working. If it works well, then after a period of strict avoidance, foods are gradually introduced, 1 at a time or 2 or 3. We typically do not do endoscopy beyond the first time and sometimes reintroducing foods is problematic since symptoms may return only slowly in many individuals. Allergy-free diet is not easy to adhere to or inexpensive to follow. Practically, the elimination diet can be challenging because of concerns with dietary contamination, issues with ingestion of restaurant prepared foods and costs of allergen-free food products. Incorporation of a dietician or allergist in patient education and dietary monitoring can enhance the success of the elimination diet approach.