What is a Food Challenge and Why Would You Need One?

A food challenge is a medical procedure in which a food is eaten slowly, in gradually increasing amounts, under medical supervision.  Food challenges are usually done when a careful medical history, combined with allergy skin or blood tests are inconclusive. A food challenge is the most definitive way to rule a food allergy in or out. Food challenges can also be done when a patient with a known food allergy appears to have possibly outgrown their food allergy based on their updated allergy tests.  

A food challenge is done in the allergy office under supervision of a board-certified allergist.  The patient needs to be feeling well on the day of the test and will be instructed to bring in the food that is being tested.  If the patient is a child who may not want to eat the food being tested, then another food that they enjoy eating can also be brought in to have the test food mixed into in order to hide the taste.  

Prior to the challenge, the patient will be examined and vital signs obtained.  The patient will then eat the implicated food in gradually increasing amounts with a period of observation after each step.  If a patient passes the oral food challenge it confirms that they are not currently allergic to that food and that they can reintroduce it at home.  Once a food challenge is passed it is generally recommended that the patient continue to ingest that food on a regular basis in order to decrease the chance of re-developing an allergy to that food in the future.  

There are risks involved with performing a food challenge to include severe allergic reactions or anaphylaxis.  For this reason, the food challenge is done in a medically supervised setting and in a graded fashion. If a patient develops symptoms during the challenge, they will be treated as appropriate and the challenge will be stopped.  

When a patient passes an oral food challenge, it can be very helpful in allowing them to reintroduce that food into their diet and no longer having to practice food avoidance measures or be worried about the risk of anaphylaxis with exposure.  

If you are interested in being evaluated for food allergies or would like to schedule a food challenge, please contact us.

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