Food Allergy and Food Intolerances

The University of Chicago Medicine provides comprehensive care for adults with food allergies and/or food intolerances.

Our goals are to:

  • Provide high-level, state-of-the art clinical care of food allergies in adults, as well as food allergies in infants, children and teens
  • 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

Our allergists and nurse practitioner have extensive experience helping people of all ages manage food allergies and food intolerences. At UChicago Medicine, your care team 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 you have (or still have) an allergy to a specific food, we may recommend an oral food challenge test.

If you have a food allergy, your care 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 you have (still have) 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 you are generally in good health and can discontinue antihistamine for a brief period (usually three days) before the test.
During the food challenge, you 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.

You will be observed for symptoms such as itching, rash, abdominal pain or difficulty breathing. If any symptoms develop, you 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 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 two 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 three 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 two weeks prior to the challenge or has had to use his or her rescue inhaler (e.g. albuterol, levalbuterol) in the two 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 two hours prior to the challenge (clear liquids are okay).
  • Bring your epinephrine autoinjector to the procedure with you.

Request an Appointment

You can also schedule an appointment instantly for in-person and video visits through our online scheduling portal.

The information you provide will enable us to assist you as efficiently as possible. A representative will contact you within one to two business days to help you schedule an appointment.

To speak to someone directly, please call 1-888-824-0200. If you have symptoms of an urgent nature, please call your doctor or go to the emergency room immediately.

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