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What is a Food Challenge?

If blood and skin testing for a potential food allergy is negative your allergist may order an in office food challenge.

A food challenge is a type of food allergy test conducted by an allergist. It is considered the “gold standard” of food tests and a highly-effective way of examining what foods an individual is allergic to. This test is also commonly known as an oral food challenge (OFC) or feeding test. You can receive a food challenge test as a child or adult. During the food challenge, you can only be tested for one food at a time.

How Does a Food Challenge Work?

During a food challenge, a patient will be gradually introduced to a specific food in increasing larger amounts to test their tolerance. As the more and more of the food is introduced to your system, the allergist will monitor to see if a patient reacts. If symptoms of a reaction start, treatment will begin immediately and the food challenge will stop.

Since this test has the potential to cause a serious allergic reaction or life-threatening anaphylaxis, the test should only be done under medical supervision. During the test, the patient is closely monitored for any negative reaction to the food.

When Do I Need a Food Challenge?

Any individual, no matter their age, can benefit from a food challenge. However, a food challenge can be extremely useful for young children who have the symptoms of an allergy (such as hives or flushing) at a young age but don’t know the trigger. It can also be conducted on older children or adults who have lived most of their lives with an allergy but want to know if they’ve outgrown it.

Are There Any Side Effects?

Since a food challenge is conducted to test an allergy, a patient may experience flushing, itching or hives or other signs of an allergic reaction.  While most allergic reactions are mild, a severe reaction may occur.

What Can I Expect Before and After a Food Challenge?

Before you or your child are expected to go to the allergy clinic for a food challenge, speak with your allergist to see if there’s anything you can or cannot do before the appointment. On most occasions, your allergist will request that the patient does not take any antihistamines (allergy medications) for three to five days prior to the food challenge.

During the test, the patient must be in 100% good health. Since the test takes approximately three to six hours, it’s a good idea to bring something to do, like a coloring book or electric device. You can expect a high level of supervision during the exam in a friendly and safe environment.

If the patient has a reaction during the test, it will be treated promptly and in accordance with the severity. For example, a mild reaction may be treated with antihistamines, while a more severe reaction would require an epinephrine auto-injector and observance for multiple hours.