title: Time to symptom improvement using elimination diets in non-IgE-mediated gastrointestinal food allergies.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Gastroenterology, Great Ormond Street Hospital for Children NHS foundation Trust, London, UK.
authors.forename: Adriana Chebar
authors.initials: AC
authors.lastname: Lozinsky
authors.affiliation: Department of Gastroenterology, Great Ormond Street Hospital for Children NHS foundation Trust, London, UK.
authors.forename: Rosan
authors.initials: R
authors.lastname: Meyer
authors.affiliation: Department Nutrition and Dietetics, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: De Koker
authors.affiliation: Department of Gastroenterology, Great Ormond Street Hospital for Children NHS foundation Trust, London, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Dziubak
authors.affiliation: Department of Gastroenterology, Great Ormond Street Hospital for Children NHS foundation Trust, London, UK.
authors.forename: Heather
authors.initials: H
authors.lastname: Godwin
authors.affiliation: Department of Gastroenterology, Great Ormond Street Hospital for Children NHS foundation Trust, London, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Reeve
authors.affiliation: Hospital Infantil Universitario Nino Jesus, Gastroenterology Department, Madrid, Spain.
authors.forename: Gloria
authors.initials: G
authors.lastname: Dominguez Ortega
authors.affiliation: Department of Gastroenterology, Great Ormond Street Hospital for Children NHS foundation Trust, London, UK.|Institute of Child Health, University College London, London, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: Shah
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000178:diet therapy* / Q000276:immunology; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000178:diet therapy* / Q000276:immunology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012074:Remission Induction; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
keywords: elimination diet; non-IgE-mediated allergy; time to improvement