In this episode, we will discuss all things related to food allergies, including the difference between IgE-mediated and non-IgE-mediated allergies, clinical manifestations, the important questions to ask when taking a history, the options for doing allergy testing, and treatment. 

Definition of food allergies
Rates of food allergies
Possible pathophysiology of food allergies


Clinical manifestations of food allergies
IgE mediated food allergies 
Cutaneous symptoms
Ocular symptoms
Respiratory symptoms
GI symptoms
Neurological and cardiovascular symptoms
Anaphylaxis = involvement of 2 or more systems


Non-IgE mediated food allergies
Symptoms after 4 hours after ingestion
Eosinophilic esophagitis
Alpha-gal
Food protein induced enterocolitis syndrome (FPIES)
Food protein induced proctocolitis (FPIAP)




Questions to ask to hone your clinical history
Presenting symptoms
When did symptoms occur
Foods ingested
Other symptoms, other exposures
Any prior allergy testing
Family history?
Any food avoidance 


Testing options for food allergies
Clinical history
Oral food challenge - gold standard
Skin prick/puncture test
Serum IgE testing


Treatment of food allergy
Referral to allergy/immunology specialist and avoidance of offending food until appointment
Prescription for epinephrine autoinjector
Second generation antihistamines



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