ACG 2025: What’s the best dietary approach for eosinophilic esophagitis management?

The four-food elimination diet plus amino acid formula (FFED + AAF) may offer a more targeted and tolerable approach for inducing remission in eosinophilic esophagitis (EoE) compared with broader or more restrictive diets, according to findings presented at American College of Gastroenterology (ACG) annual scientific meeting.

This systematic review and network meta-analysis compared six dietary strategies for managing EoE, focusing on histological remission (≤15 eosinophils/high-power field). Analyzing seven studies involving 567 patients, FFED + AAF ranked highest (p-score = 0.84), outperforming the elemental diet and one-food elimination diet. The six-food elimination diet plus amino acids (SFED + AAF) was least effective (p-score = 0.30). Researchers emphasized that FFED offers a more practical and effective starting point for dietary therapy, balancing efficacy with patient adherence.

Source:

Abideen Z, et al. “Comparing Different Elimination Diets in the Treatment of Eosinophilic Esophagitis: A Systematic Review and Network Meta-Analysis” [Poster]. Presented at ACG 2025 Annual Scientific Meeting. https://acg2025posters.eventscribe.net/fsPopup.asp?PosterID=750891&Query=0612&mode=posterInfo. Accessed October 29, 2025.