Oral food challenges safe when performed in doctor’s office

(Reuters Health) – Oral food challenges at the doctor’s office are a safe way to diagnose food allergies, a U.S. study suggests.

Based on records of more than 6,000 food challenge tests done in allergy practices in Houston, Pittsburgh, Seattle, Boston and Indianapolis, researchers found that only 2 percent produced a severe allergic reaction known as anaphylaxis.

Across practices, just 13 percent to 33 percent of patients had any type of allergic reaction.

In oral food challenges, patients consume a very small amount of food by mouth while doctors watch for an allergic reaction.

“Parents should know it’s safe in a clinic with a physician that’s skilled in performing oral food challenges,” said senior study author Dr. Carla Davis, a pediatric allergist at Texas Children’s Hospital in Houston.

Oral food challenge is the current gold standard for food allergy testing, she told Reuters Health by phone. “We don’t have another test that very accurately lets us know if a person is going to react to food if they eat it. The food challenge, unfortunately at this time, is the only way to determine if a person has a life-threatening food allergy or not.”

Past research has mainly focused on experiences at individual allergy clinics, Davis and her colleagues write in the Annals of Allergy, Asthma and Immunology. To get a broader picture of the safety of oral food challenges across the U.S., they examined records from five practices over a five-year period.

All tests were performed under the guidance of medical professionals. Most of the patients were under age 18.

Just 2 percent of those being tested experienced anaphylaxis, which requires immediate medical intervention. About 14 percent had mild or moderate reactions such as hives on the skin and were usually treated with antihistamines.

Davis said that if parents suspect their kids have food allergies, the best place to start is with their local allergist.

“They can also see their primary care physician because primary physicians can talk with them about symptoms as well as possibly do some screening laboratory tests to see if they need to go to an allergist,” she said.

Typical symptoms of allergic reactions to food include coughing or wheezing, vomiting and abdominal pain, hives, skin swelling, lip swelling and throat tightness, she said.

“A medically supervised feeding test (oral food challenge) is the most definitive type of allergy test,” said Dr. Scott Sicherer, a pediatric…

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