Allergies & Intolerances
The University of Chicago Medicine provides comprehensive care for infants, children, teens and adults with food allergies and/or food intolerances.
Our goals are to:
- Provide high-level, state-of-the art clinical care of food allergies
- Help new and expecting mothers to prevent the development of food allergies in their children
- Work with community organizations, businesses, schools and churches to increase awareness of food allergies and to ensure preparedness in case of a food allergic reaction
- Quickly translate findings made in the laboratory to trials in the clinic
Signs & Symptoms of Food Allergies
Signs of an allergic reaction to food or medication may include itchy mouth, hives, swelling, gastrointestinal symptoms, such as vomiting or diarrhea and — in severe cases — swelling of the throat and difficulty breathing. It's important that anyone who experiences difficulties breathing goes to the emergency room right away.
Working with Our Team
When you see an allergist at UChicago Medicine, they will take a comprehensive medical history, perform a physical exam, and may use a skin prick test and/or blood test to check for food allergies. If allergy test results and medical history are inconclusive, and do not show whether or not your child has (or still has) an allergy to a specific food, we may recommend an oral food challenge test.
If you or your child has a food allergy, our team will work with you to develop a comprehensive management plan. This plan will include strategies for avoiding foods or medications that trigger reactions, as well as creating an emergency plan to treat reactions if they occur. Your provider may discuss experimental treatments for food allergy.
Oral Food Challenge
If allergy test results and medical history do not show for certain whether or not your child has (still has) a food allergy to a specific food, we recommend performing an oral food challenge test.
The oral food challenge involves eating a serving of the allergic food in a slow, graded fashion under medical supervision. The food challenge procedure is the most accurate test to determine whether a food needs to be avoided or will no longer need to be avoided.
The food challenge is undertaken when your child is in generally good health and can discontinue antihistamine for a brief period (usually 3 days) before the test.
During the food challenge, your child will be given very small amounts of the specific food being tested. If tolerated, increasing amounts of the challenge food will be given with close observation at each stage.
Your child will be observed for symptoms such as itching, rash, abdominal pain or difficulty breathing. If any symptoms develop, your child will be treated immediately. In most cases, this will involve the use of diphenhydramine and/or epinephrine to prevent any allergic reactions from getting worse. In studies of food challenges, many children develop mild symptoms during a food challenge that require these treatments. Very rarely, other treatments are needed for more serious reactions.
In some cases, your doctor may decide to place an IV in your child’s arm before the challenge starts. This would be used to give medicine if needed.
In some cases, the food challenge is performed by masking the food to hide the taste, and using food that looks/tastes the same but does not contain the food being tested . This is called a placebo. These procedures reduce the possibility that we would misjudge a reaction to the food that could occur from fear or distaste of the new food.
The discomforts associated with the food challenge are generally no more than those encountered when eating the food. Symptoms usually are short-lived (less than 2 hours). Symptoms may include an itchy skin rash, nausea, abdominal discomfort, vomiting, diarrhea, stuffy “runny” nose, sneezing or wheezing.
Major risks include severe breathing difficulties and, in rare cases, a drop in blood pressure. While a severe outcome such as death is theoretically possible, this has not occurred from medically supervised oral food challenges. The risk of a reaction is reduced by starting the challenge with very small amounts of food, administering the food over a prolonged time period, stopping the challenge at the first sign of a reaction and by not giving any food suspected to cause a major reaction.
Medications, personnel and equipment will be immediately available to treat allergic reactions should they occur.
It is common for a young child to become stubborn and refuse to ingest the challenge food. Allowing the use of well-cleansed utensils and dinnerware that are familiar, like a favorite cup or spoon, makes the challenge appear more natural as well. Diversions, such as toys, games, or DVDs, are also helpful.
- Stop all antihistamines 3 days before the challenge (e.g. cetirizine, loratidine, fexofenadine, diphenhydramine).
- Continue all asthma medications even on the day of the challenge.
- Contact your doctor if your child has been on oral steroids (e.g. prednisone, prednisolone, etc.) in the 2 weeks prior to the challenge or has had to use his or her rescue inhaler (e.g. albuterol, levalbuterol) in the 2 days prior to the challenge.
- Pack a bag with games, toys and DVDs to bring to the oral food challenge since you'll at the procedure for several hours.
- Pack food that will be used for the challenge as instructed by your doctor.
- Call before leaving for the challenge if your child develops a fever, nausea, vomiting, wheezing or other illness.
- No food 2 hours prior to the challenge (clear liquids are okay).
- Bring your epinephrine autoinjector to the procedure with you.