What to Eat When You Have Eosinophilic Gastritis

Dietary Recommendations for Better Management

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If you’re living with eosinophilic gastritis, a condition that causes inflammation in the digestive system, knowing which foods to eat and which to avoid can be a challenge. Many people with eosinophilic gastritis follow a special diet, such as an elimination diet or elemental diet, that may help provide relief from symptoms.  

While eating a specific diet won’t cure eosinophilic gastritis, this article will discuss nutritional strategies that can help reduce symptoms and improve your overall health and well-being.

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Benefits

There is a strong association between food allergies and eosinophilic gastritis. The six foods most commonly associated with allergies are:

  • Dairy
  • Eggs
  • Tree nuts
  • Soy
  • Seafood/shellfish
  • Wheat

For this reason, following a diet that eliminates these foods, known as the multiple-food elimination diet (MFED), may be helpful in reducing your symptoms.

Research shows that eosinophilic gastritis is very responsive to dietary restrictions, particularly in children.

Research also indicates that the MFED is a promising treatment for people with eosinophilic gastritis.

In one study, patients on a multiple-food elimination diet saw improved symptoms and a reduction in levels of eosinophils, which are disease-fighting white blood cells that, in large quantities, can cause inflammation and damage in the stomach.

How It Works 

An elimination diet typically involves four steps that take place over the span of four to six weeks. The multiple-food elimination diet should only be followed with the guidance of a dietitian.

Step 1: Planning

The planning stage should include the following steps:

  1. Along with your healthcare provider or dietitian, identify which foods may be causing symptoms or triggering flares (times when symptoms worsen).
  2. Plan a date to begin the diet.
  3. Prepare ahead of time so you're ready to begin on the set date.
  4. Go grocery shopping for the foods you will need.
  5. Meal plan in advance to take out the guesswork of what you will eat.
Noncompliant Foods
  • Dairy

  • Eggs

  • Soy

  • Wheat

  • Tree nuts

  • Shellfish

Compliant Foods
  • Dairy substitutes (coconut milk, rice milk)

  • Fruits and vegetables

  • Wheat-free grains

  • Gluten-free foods

  • Meats

  • Oils and fats


Step 2: Elimination

Follow the elimination diet for two to four weeks and avoid all noncompliant foods. This includes milk, soy, eggs, wheat, peanuts/tree nuts, and shellfish/fish.

Be sure to read the ingredients list of any prepackaged foods to ensure you avoid trigger foods. This requires a lot of discipline and diligence, as you must pay careful attention to food labels.

At the start of this phase, you may notice that your symptoms feel worse before they begin to improve. If your symptoms worsen for more than a day or two, talk with your healthcare provider.

Step 3: Challenge

If your symptoms improve during the elimination phase, you can begin to “challenge” your body by reintroducing foods to your diet, one at a time.

On the day you begin to eat an eliminated food, start with a small amount. If you don’t notice any symptoms, you can increase the amount you eat.

Keep a written log of the foods you eat and any symptoms you have. Symptoms to look out for include acid reflux, heartburn, abdominal pain, nausea, vomiting, or difficulty swallowing.

If a food that you’ve reintroduced to your diet doesn’t cause any symptoms, it is likely that you are not allergic to that food and you can add it back into your diet. You can reintroduce new foods every three days, but do not add two or more eliminated foods at the same time. 

Step 4: Creating a Long-Term Diet

Once you’ve completed the challenge, you will know which foods you can tolerate and which you need to avoid long term. Work with your dietitian or healthcare provider to develop a long-term diet plan. 

Try to be as consistent as possible and stick to the foods you know your body can handle. If you add certain foods back to your diet that your body can’t tolerate, you may have a recurrence of symptoms.

Recommended Timing 

When following the MFED, you can eat on a schedule that works for you and your lifestyle. Do your best to ensure you eat three meals a day, with healthy snacks in between if you feel hungry. 

When reintroducing foods in the challenge phase, be sure to wait three days before adding another to your diet. This gives you enough time to watch and wait for any symptoms that may be caused by that particular food. 

Duration

The MFED generally lasts from four to six weeks. This provides adequate time to completely eliminate the noncompliant foods and slowly reintroduce each food to determine which are contributing to your symptoms.

Cooking Tips 

If you’re used to cooking and eating certain foods that you now need to avoid, following an elimination diet can be challenging. Remember that the elimination diet is a short-term test rather than a long-term commitment. 

When eliminating certain foods, be sure to replace the nutrients in those foods with an alternate source. For example, if you can't tolerate dairy, make sure you get plenty of calcium from other sources, such as leafy green vegetables like spinach, kale, and dark-leaf lettuce.

Modifications

An elimination diet is highly individualized, and modifications can be made if you follow a certain diet already, such as a vegetarian diet. Talk with your healthcare provider or dietitian, who can help you develop the right elimination diet for you. 

Considerations 

Adhering to an elimination diet can feel daunting. Rather than focusing on what you can’t eat, think about how your dietary changes will help you feel better in the long run. The elimination diet is a temporary time to help you achieve long-term health and wellness. 

There are a number of elimination diet support groups online. You can find camaraderie, recipes, and tips from others who are currently going through it or have done it in the past.

Dietary Restrictions 

Following the MFED comes with dietary restrictions, as you begin avoiding certain foods and slowly adding them back into your diet. While you’re going through the process, try to eat as many whole, fresh foods as you can.

Along with avoiding common food allergens, try to reduce your intake of processed foods, alcohol, and sugar-sweetened drinks. This will help boost your energy levels, strengthen your immune system, and reduce inflammation in your body.

Multiple-Food Elimination Diet vs. Other Diets 

Some people with eosinophilic gastritis may try other diets to reduce symptoms and encourage remission under the guidance of a medical professional.

Elemental Diet

An elemental diet is a restrictive diet that replaces foods with nutritionally complete formulas that come in liquid and powder forms. Elemental formulas can provide all the nutrients—including vitamins and minerals—that your body needs.

These diets must only be started when under the guidance and supervision of a healthcare professional. Your healthcare provider or a registered dietitian will recommend the amount and type of formula you should consume based on your health status and caloric needs. 

Drinking your calories may make you feel tired and hungry. If you are not getting enough calories or nutrients, you may lose weight on an elemental diet.

Skin Test–Directed Diet 

Before you begin a skin test–directed diet, you will have a skin prick allergy test. The test involves a healthcare provider placing food allergens on your back or forearm.

Using a small needle, they will gently scratch the surface of your skin to allow a small amount of the food substance to enter just below the surface of your skin. If you are allergic to a specific food, a raised bump and itchy red skin will appear.

Once it is determined which foods you are allergic to, you will eliminate these from your diet long term to avoid eosinophilic gastritis flares. 

Summary

Eosinophilic gastritis is a condition that causes inflammation throughout the digestive system. Certain foods can exacerbate symptoms, so some people follow a multiple-food elimination diet, which involves eliminating the common food allergens dairy, eggs, soy, shellfish, tree nuts, and wheat. Eating a specific diet will not cure eosinophilic gastritis, but it can provide symptom relief and improve your overall well-being.

A Word From Verywell 

Following an elimination diet isn’t always easy, but it is a temporary challenge that may have long-term benefits for your health and well-being. It can be difficult to stop eating foods that you love, but having a positive attitude and anticipating feeling better can go a long way toward helping you get through it. Talk with your healthcare provider or a registered dietitian before beginning an elimination diet. They can provide you with guidance and support.

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4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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