What is EoE and EGID?

Eosinophilic esophagitis (EoE) is a chronic (lifelong), allergic disease of the esophagus (the tube that links your mouth and stomach).  

Eosinophilic gastrointestinal disorders (EGIDs) can happen when there are high levels of eosinophils in one or more parts of the digestive system.  

These disorders occur when a type of white blood cell involved in allergic reactions, the eosinophil, builds up in the esophagus or other part of the digestive tract. It causes inflammation, or swelling, and difficulty swallowing. Learn more about EoE including symptoms, facts and getting tested. 

Finding out you have EoE or EGID can only be done by an endoscopy (a test your gastroenterologist does to see inside part of your digestive system) and taking small tissue samples of the esophagus. 

What is the SFED diet?

The most common type of food elimination diet is the six food elimination diet (SFED).

  • This type of diet has shown success in about 70% of patients.
  • Instead of taking away foods based on allergy testing results, you will stop eating common allergy-causing foods (milk, eggs, wheat, soy, peanuts/tree nuts, fish/shellfish).
  • This process often lasts about six to eight weeks before you will have a follow up endoscopy.
  • If your EoE is not active following dietary elimination, then serial food reintroduction can start to identify what foods are causing your allergy. Typically, one to two foods are reintroduced at a time, and a follow up endoscopy can confirm disease activity in response to foods added.

Choosing safe and healthy foods on the six food elimination diet

Grains Proteins Fruits and vegetables
5+ servings daily
Daily Alternative Fats and oils
Quinoa, rice, corn, corn products
Chicken, turkey, pork, beef, lamb
Fresh, canned, frozen, or dried fruit and juices
Coconut milk and yogurt
Potatoes/sweet potatoes
Protein powders: rice, hemp, pea, quinoa
Fresh, canned or frozen vegetables
Fresh, canned or frozen vegetables
Oils, including olive, avocado, vegetable oils*
Millet, tapioca, teff, buckwheat
Seeds and sunflower seed butter
Vegan cheese products (soy-free)**
Dairy free and soy free margarine
Dairy free and soy free margarine
Vegan mayo
* Highly refined soybean oils found in vegetable oil do not usually contain soy protein and are allowed on SFED. Cold pressed and expeller pressed oils can be sources of soy protein and should be avoided.

Avoiding cross contamination

Avoiding allergens and reducing cross contamination can improve how well you do on the diet:

  • Stay away from salad bars, buffets, and hot bars where food and serving tools, forks, knives, etc., can be mixed.
  • Don’t use bulk bins and bulk condiments at restaurants where food proteins can mix.
  • Don’t eat fried foods from restaurants as the oil may also be used to fry foods with wheat or other allergens.
  • Tell restaurants and ask for safe food handling such as using fresh gloves, clean prep and cooking surfaces, and clean utensils.
  • Tell friends and family of your food allergies so they can help offer you safe food.
  • Bring supplies and snacks to social events in case safe foods are not available.
  • Choose gluten-free oats since regular oats will be contaminated with wheat.

1-Day sample menu on the SFED:

  • 1 cup gluten free oatmeal: top with 1 tbsp flax seeds, ½ cup blueberries and 1 cup calcium fortified coconut milk (or other allowed milk)
  • Coffee or tea
  • 2 cups mixed green salad with veggies of choice, 4-6oz grilled chicken, sunflower seeds, and homemade vinaigrette or olive oil and vinegar
  • ½ cup sliced strawberries
  • 2 brown rice cakes with 2 tbsp sunflower seed butter and apple slices
  • Coconut yogurt and berries
  • 4 oz grilled flank steak
  • 1 medium baked sweet potato with Earth Balance Organic Soy Free Butter®
  • ½ cup berry sorbet
  • Sparkling water
Now it is time to meet with a GI-expert dietitian. To get more information about this topic, find a dietitian in your area using our Find a Health Care Provider tool.

Written by

Emily Haller, MS, RDN, Lauren Van Dam, MS, RDN, CNSC, and
Bethany Doerfler, MS, RDN
Reviewed by the DIGID Upper Gut Workgroup ©March 2021