Should wheat, barley, rye, and/or gluten be avoided in a 6-food elimination diet?

Kara L. Kliewer, Carina Venter, Alison M. Cassin, J. Pablo Abonia, Seema S. Aceves, Peter A. Bonis, Evan S. Dellon, Gary W. Falk, Glenn T. Furuta, Nirmala Gonsalves, Sandeep K. Gupta, Ikuo Hirano, Amir Kagalwalla, John Leung, Vincent A. Mukkada, Jonathan M. Spergel, Marc E. Rothenberg

Research output: Contribution to journalArticle

15 Scopus citations


Eosinophilic esophagitis (EoE), a food antigen-mediated disease, is effectively treated with the dietary elimination of 6 foods commonly associated with food allergies (milk, wheat, egg, soy, tree nuts/peanuts, and fish/shellfish). Because wheat shares homologous proteins (including gluten) with barley and rye and can also be processed with these grains, some clinicians have suggested that barley and rye might also trigger EoE as a result of cross-reaction and/or cross-contamination with wheat. In this article, we discuss the theoretical risks of cross-reactivity and cross-contamination among wheat, barley, and rye proteins (including gluten); assess common practices at EoE treatment centers; and provide recommendations for dietary treatment and future studies of EoE.

Original languageEnglish (US)
Pages (from-to)1011-1014
Number of pages4
JournalJournal of Allergy and Clinical Immunology
Issue number4
StatePublished - Apr 1 2016



  • 6-food elimination diet
  • Eosinophilic esophagitis
  • cross-reactivity
  • gluten
  • wheat

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Kliewer, K. L., Venter, C., Cassin, A. M., Abonia, J. P., Aceves, S. S., Bonis, P. A., Dellon, E. S., Falk, G. W., Furuta, G. T., Gonsalves, N., Gupta, S. K., Hirano, I., Kagalwalla, A., Leung, J., Mukkada, V. A., Spergel, J. M., & Rothenberg, M. E. (2016). Should wheat, barley, rye, and/or gluten be avoided in a 6-food elimination diet? Journal of Allergy and Clinical Immunology, 137(4), 1011-1014.