The elimination diet involves removing specific foods or ingredients from your diet that you and your doctor suspect may be causing your allergy symptoms. (Common allergy-causing foods are milk, eggs, peanuts, tree nuts, wheat, and soy in infants and children; and peanuts, tree nuts, shellfish in adults) Your doctor will supervise this diet over two to three weeks.
During this time, you will need to carefully read food labels and find out about food preparation methods when dining out. You’ll also keep a food diary to record the foods you are eating. If you remove a certain food and the symptoms go away while following this diet, your doctor can usually identify that food as the cause of your problems.
While following this diet, make sure you are eating other foods that provide the same nutrients as those you've eliminated (such as trying tofu-based foods instead of dairy products). A dietitian can help you plan meals that are healthful and nutritious without including the potentially allergenic foods.
After following the elimination diet, your doctor will tell you when to gradually reintroduce the foods you were avoiding into your diet, one at a time. This process can help link symptoms to specific foods.
You will need to carefully record any symptoms that occur when you eat each of these foods. If your symptoms return after eating the food, the diagnosis can usually be strongly suspected to be this food. Further confirmation can be with allergy skin or blood testing, if available for the suspected food. You will be asked once again to eliminate the foods that have been identified as causing symptoms to see if the symptoms clear up.
However, this is not a foolproof method. Psychological and physical factors can affect the diet's results. For example, if you think you're sensitive to a food, a response could occur that may not be a true allergic one.
Before making significant changes in your diet, always seek the advice of your doctor. If you randomly remove foods from your diet, you may not have a balanced diet—and a lack of some nutrients can cause other health problems. You may also become frustrated because it may seem that everything you eat is causing a reaction.
If you've had a severe (anaphylactic) reaction to certain foods, this method can't be used.
What is a controlled food challenge?
In a controlled environment such as an intensive care hospital unit, the doctor (usually a board-certified allergist) may conduct a food challenge test to determine if a food allergy exists or to confirm a suspected food allergy.
Samples of the suspected offending food may be mixed with another food or may be disguised as an ingredient in another food. These food preparation techniques are used to prevent undue influence on the outcome of the test (if the person recognizes the food by sight or taste). Another method is to have you take a capsule containing the allergen.
You eat the food or take the capsule under strict supervision. After eating the food or taking the capsule, you will be monitored to see if a reaction occurs.
The ideal way to perform the food challenge test is as a "double-blind, placebo-controlled test." With this method, neither the allergist nor the patient is aware of which capsule, or food, contains the suspected allergen. In order for the test to be effective, you must also take capsules or eat food that does not contain the allergen. This will help the allergist make sure the reaction, if any, being observed is due to the allergen and not some other factor.
Someone with a history of severe reactions cannot participate in a food challenge test. In addition, multiple food allergies are difficult to evaluate with this test.
Since this test takes a lot of time to perform, it is costly and done infrequently. This type of testing is generally used when the doctor needs to confirm or eliminate specific food allergens.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 1/23/2007...#9544
