Food allergies are more prevalent than ever before, with increasing reports of emergency room visits for allergic reactions. A food allergy diagnosis can be overwhelming; with a personalized treatment plan, we can help make this diagnosis bearable for the patient and their family. We also evaluate and treat other types of allergic conditions that can be associated with foods, but cause different reactions than those typically associated with food allergies. We offer evaluations and treatments for the following conditions:
Food allergy testing and evaluation: Food allergy cannot be diagnosed with testing alone. A detailed clinical history of the food reaction along with skin testing and/or blood testing is often necessary to make an accurate diagnosis. It is important that the patient receives an accurate diagnosis to clearly identify the level of risk with exposure and so that all possible treatment options can be considered.
Early introduction: Numerous studies have shown the importance of early peanut introduction in order to avoid a peanut allergy. This is especially important for infants at high risk, such as those with moderate/severe eczema or a pre-existing food allergy. Current guidelines recommend that these infants be evaluated at 4-6 months of age to see if it is safe for them to introduce peanut to avoid peanut allergy
Oral immunotherapy (OIT): OIT is a new treatment option that was approved by the FDA in 2019 (PalforziaTM) which involves feeding a small dose of peanut to peanut allergic individuals in a controlled setting . OIT does not cure a peanut allergy, but has been shown in some individuals to prevent reactions from accidental exposures.
Oral food challenges: Skin tests and blood tests help with the diagnosis of food allergy, but consumption of the food is the gold standard. If an oral challenge is deemed appropriate by the physician, patients consume the subject food in increasing amounts over a few hours under close supervision for signs of a reaction. Oral food challenges are not routinely offered if the likelihood is high that the patient will fail the challenge. Passing a food challenge can clear a patient of a food allergy.
Food Protein Induced Enterocolitis Syndrome (FPIES): FPIES is associated with food allergies, but it is not the type of allergy people typically think about when they think of allergies to foods. FPIES normally occurs in children, but it can also occur in adults. The reaction usually involves severe vomiting that can sometimes cause dehydration and shock. Standard allergy tests are often performed in the context of FPIES to rule out a diagnosis of food allergy; these tests are not routinely positive in this condition.
Eosinophilic Esophagitis (EoE): EoE is a condition that can be associated with foods. EoE can range from poor growth in children, to slow eating or recurrent vomiting, to difficulty swallowing and getting foods stuck in your throat. A diagnosis is made by biopsy that looks for a certain number of cells in the esophagus, called an eosinophil that is associated with allergy. Testing for food (and environmental) allergies can occasionally be useful for patients with EoE.