Time to symptom improvement using elimination diets in non-IgE-mediated gastrointestinal food allergies

Pediatr Allergy Immunol. 2015 Aug;26(5):403-8. doi: 10.1111/pai.12404.


Background: The prevalence of food allergy has increased in recent decades, and there is paucity of data on time to symptom improvement using elimination diets in non-Immunoglobulin E (IgE)-mediated food allergies. We therefore aimed to assess the time required to improvement of symptoms using a symptom questionnaire for children with non-IgE-mediated food allergies on an elimination diet.

Methods: A prospective observational study was performed on patients with non-IgE-mediated gastrointestinal food allergies on an elimination diet, who completed a questionnaire that includes nine evidence-based food allergic symptoms before and after the exclusion diet. The questionnaire measured symptoms individually from 0 (no symptom) to 5 (most severe) and collectively from 0 to 45. Children were only enrolled in the study if collectively symptoms improved with the dietary elimination within 4 or 8 weeks.

Results: Data from 131 patients were analysed including 90 boys with a median age of 21 months [IQR: 7 to 66]. Based on the symptom questionnaire, 129 patients (98.4%) improved after 4-week elimination diet and only two patients improved after 8 weeks. A statistically significant difference before and after commencing the elimination diet was seen in all nine recorded symptoms (all p < 0.001), and in the median of overall score (p < 0.001).

Conclusion: This is the first study attempting to establish time to improve after commencing the diet elimination. Almost all children in this study improved within 4 weeks of following the elimination diet, under dietary supervision.

Keywords: elimination diet; non-IgE-mediated allergy; time to improvement.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Food Hypersensitivity / diagnosis
  • Food Hypersensitivity / diet therapy*
  • Food Hypersensitivity / immunology
  • Gastrointestinal Diseases / diagnosis
  • Gastrointestinal Diseases / diet therapy*
  • Gastrointestinal Diseases / immunology
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Prospective Studies
  • Remission Induction
  • Risk Factors
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome