Challenge (food allergy)

Definition

Gradual and controlled reintroduction of an allergenic food after exclusion to evaluate tolerance.

How it works

Food challenge involves gradually reintroducing an excluded food to confirm its role in symptoms or evaluate potential improvement in tolerance. This phase typically follows a diagnostic exclusion period and must be conducted in a safe medical setting. Reintroduction is done by gradually increasing quantities and frequency. This approach helps differentiate between true allergy and intolerance, and identifies the minimum tolerated quantity. This approach is essential for children to allow for an appropriate food reintegration.

Role

Evaluate tolerance after exclusion and identify the reaction threshold to an allergen.

Examples

• Reintroducing eggs in children
• Reintroducing milk after exclusion diet
• Gradual reintroduction of peanuts
• Reintroducing wheat after evasion

Recommendations

Always reintroduce under medical supervision to detect potential reactions. Proceed very gradually by increasing quantity and frequency over several weeks. Have antihistamines or an epinephrine auto-injector available in case of a severe reaction.

Key takeaway

Controlled reintroduction of an allergen evaluates tolerance and allows for safe food reintegration.

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