Effect of Amino acid formula on esophageal inflammation and intestinal permeability in adult Eosinophilic esophagitis patients

Eosinophilic esophagitis (EoE) is an increasingly encountered disease for which yet no acceptable medical treatment exists. There is sufficient evidence to state that food allergy plays an important role in EoE and dietary treatment has proven efficacy in these patients. It has been suggested that elemental nutrition is an effective treatment for these patients. In this trial we will study the effect of Neocate elemental nutrition on the esophageal eosinophilic inflammation in adult patients with eosinophilic esophagitis. Furthermroe we will study the effect of Neocate elemental nutrition on esophageal and intestinal mucosal integrity, esophageal inflammation, endoscopic signs, symptoms and quality of life, and the gastrointestinal microbiome in these patients.The EoE patients will consume an elemental diet for 4 weeks. Baseline upper endoscopy with tissue impedance measurements is performed and esophageal & duodenal biopsies are taken in EoE patients and healthy volunteers. Symptoms, quality of life, and product acceptability are being investigated using questionnaires. Furthermore, the intestinal barrier function will be measured using a dual sugar method by calculating lactulose:mannitol (L:M) ratio and saliva and feces are collected to optionally assess the indigenous microbiota. In EoE patients, these measurements are repeated after 4 weeks of elemental nutrition.

To study the effect of Neocate elemental nutrition on the esophageal eosinophilic inflammation in adult patients with eosinophilic esophagitis. Secondary: to study the effect of Neocate elemental nutrition on esophageal and intestinal mucosal integrity, esophageal inflammation, endoscopic signs, symptoms and quality of life, and the gastrointestinal microbiome in these patients.

The EoE patients will consume an elemental diet for 4 weeks. Baseline upper endoscopy with tissue impedance measurements is performed and esophageal & duodenal biopsies are taken in EoE patients and healthy volunteers. Symptoms, quality of life, and product acceptability are being investigated using questionnaires. Furthermore, the intestinal barrier function will be measured using a dual sugar method by calculating lactulose:mannitol (L:M) ratio and saliva and feces are collected to optionally assess the indigenous microbiota. In EoE patients, these measurements are repeated after 4 weeks of elemental nutrition.

Elemental diet preceded by and followed by gastroscopy, vena puncture, salive, feces and urine analysis.