Review article: cinnamon- and benzoate-free diet as a primary treatment for orofacial granulomatosis
Alimentary Pharmacology and Therapeutics, 08/08/2011
Campbell HE et al. – Management of orofacial granulomatosis is challenging but cinnamon– and benzoate–free diets appear to have a definite role to play.Methods
- 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.
- 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%).
- Cinnamon- and benzoate-free diet has been shown to provide benefit in 54-78% of patients with 23% requiring no adjunctive therapies.
- Negative or positive patch test result to cinnamaldehyde, and benzoates did not predict dietary outcome.
- 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.