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Review article: cinnamon- and benzoate-free diet as a primary treatment for orofacial granulomatosis.
MedLine Citation:
PMID:  21815899     Owner:  NLM     Status:  Publisher    
Background  Orofacial granulomatosis is a rare chronic granulomatous inflammatory disease of the lips, face and mouth. The aetiology remains unclear but may involve an allergic component. Improvements have been reported with cinnamon- and benzoate-free diets. Aims  To explore the prevalence of compound and food sensitivity and examine the dietary treatments used in orofacial granulomatosis. Methods  A comprehensive literature search was carried out and relevant studies from January 1933 to January 2010 were identified using the electronic database search engines; AGRIS 1991-2008, AMED 1985-2008, British Nursing and Index archive 1985-2008, EMBASE 1980-2008, evidence based medicine review databases (e.g. Cochrane DSR), International Pharmaceutical and Medline 1950-2008. Results  Common sensitivities identified, predominantly through patch testing, were to benzoic acid (36%) food additives (33%), perfumes and flavourings (28%), cinnamaldehyde (27%), cinnamon (17%), benzoates (17%) and chocolate (11%). The cinnamon- and benzoate-free diet has been shown to provide benefit in 54-78% of patients with 23% requiring no adjunctive therapies. A negative or positive patch test result to cinnamaldehyde, and benzoates did not predict dietary outcome. The most concentrated source of benzoate exposure is from food preservatives. Use of liquid enteral formulas can offer a further dietary therapy, particularly in children with orofacial granulomatosis. Conclusion  Management of orofacial granulomatosis is challenging but cinnamon- and benzoate-free diets appear to have a definite role to play.
H E Campbell; M P Escudier; P Patel; S J Challacombe; J D Sanderson; M C E Lomer
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-4
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  -     ISSN:  1365-2036     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Diabetes and Nutritional Sciences Division, King's College London (KCL), London, UK. Department of Nutrition and Dietetics, Guy's and St Thomas' NHS Foundation Trust (GSTFT), London, UK. NIHR Comprehensive Biomedical Research Centre at GSTFT and KCL, London, UK. Department of Oral Medicine, King's College London Dental Institute, London, UK. Department of Gastroenterology, GSTFT, London, UK.
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