Elimination Diets

In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.


An elimination diet is a commonly utilized dietary approach in which a particular food or group of foods is removed from the diet. Elimination diets can be employed to identify and treat food intolerances, food allergies, and other disorders, such as urticarial disease, eosinophilic esophagitis, irritable bowel syndrome, or migraine headaches.

The specific protocol that guides each elimination diet is dictated by the presenting symptoms or established disease process. The elimination process can either be directed by food allergen testing or instituted empirically. Highly regimented elimination diets exist, including the gluten-free diet and the low-FODMAP (Fermentable Oligo-, Di-, Monosaccharides, and Polyols) diet. For severe food-related reactions, such as anaphylaxis, other diagnostic avenues, including skin prick tests, serum-specific IgE measurements, or component-resolved diagnostics, can be employed before an elimination diet with oral food challenges is pursued.

Elimination diets have proven efficacy in symptom control and patient satisfaction in various disease processes and are backed by various randomized control trials and observational studies. This activity reviews commonly utilized elimination diets, the disease processes they may help identify and treat, the limitations of such diets, and the optimal approach to improving patient outcomes through their implementation.

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