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Food Allergies

Food allergies are very unpredictable and can become more or less severe over time. They can range from minor inflammation to severe, life-threatening anaphylaxis (a whole-body allergic reaction).

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Food allergies should be taken very seriously

The best way to prevent a food allergy reaction is by avoiding known food triggers altogether. Some of the most common food allergies are to milk, eggs, fish, shellfish and nuts.

Once your food allergy trigger is identified, you can protect yourself by alerting friends, family and others of your food allergies. That way, you can savor flavors without worrying about surprise ingredients or cross-contamination.

Patient with food allergies reading the ingredients on a food product in the grocery store and happy to find out it does not list their intolerance.
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In addition to offering care for a number of food allergy conditions, we treat conditions that are commonly linked to food allergies, including:

Abdominal pain associated with food ingestion
Celiac disease
Contact dermatitis
Eosinopilic esophagitis
Exercise induced anaphylaxis
Food aversion/phobia
Food intolerance
Food protein induced entercolitis syndromes (FPIES)
Food protein-induced proctitis/colitis and enteropathy of infancy
Immunoglobulin (IgE)-mediated food allergies (e.g., peanut allergy, cow milk allergy, etc.)
Non-celiac gluten hypersensitivity
Oral allergy syndrome


Food allergies are very complex and can be tricky to diagnose. Preparing for your visit with medical records is always helpful, especially if you’re a new patient.

At your initial visit, you can expect us to:

  • Review your medical history, such as hospital discharge summaries, physician office records and X-ray reports  
  • Review your environmental, occupational, social and family history  
  • Conduct a physical examination  
  • Do skin testing, lung function testing and laboratory tests, if needed  

Special procedures, such as drug challenges, drug testing and certain desensitization treatments, will generally be scheduled for a future visit.

Skin testing

If skin testing is recommended, you’ll need to refrain from taking the following medications for 7 days before your visit:

  • Diphenhydramine (Benadryl)
  • Chlorpheniramine (Chlor-Trimeton)
  • Brompheniramine (Dimetapp)
  • Clemastine (Tavist, Antihist)
  • Cyproheptadine (Periactin)
  • Doxepin (Adapin, Silenor, Sinequan)
  • Combination Drugs (Actifed, Drixoral, Trinalin)
  • Loratadine (Claritin)
  • Fexofenadine (Allegra)
  • Cetirizine (Zyrtec)
  • Hydroxyzine (Vistaril, Atarax)
  • Azelastine nasal spray (Astelin, Asteopro)
  • Olopatadine nasal spray (Patanase)
  • Some over-the-counter sleep aids

Hydrogen breath test

A hydrogen breath test takes about three hours to complete. It provides information about how you digest certain sugars or carbohydrates, such as lactose (milk sugar) and fructose (fruit sugar). The test also detects abnormal growth of bacteria within the small bowel. Bacterial overgrowth can cause a variety of symptoms, like:

  • Bloating
  • Diarrhea
  • Burping
  • Abdominal cramps

How to prepare for hydrogen breath testing

4 weeks before your test

For 4 weeks before your test, you should not take any antibiotics.

1 week before your test

For 1 week before your test, avoid:

  • Laxatives and stool softeners (Colace®, Milk of Magnesia®, Ex-Lax®)
  • Stool bulking agents (for example Metamucil® or Citrucel®)
  • Any test that requires cleansing of the bowel, such as a colonoscopy or barium enema
Day before your test

We’ve put together eating guidelines so you don’t have to worry about what and what not to eat the day before your hydrogen breath test. You must stick to the following list because eating or drinking anything else could lead to false test results.

We also recommend an early dinner of rice and meat the night before your test.

Foods you can eatDon't eat the following foods
  • Plain white bread
  • Plain white rice
  • Plain white potatoes
  • Baked or broiled chicken or fish
  • Water
  • Non-flavored black coffee or tea
  • Only salt may be used to flavor food
  • Butter and margarine
  • Soda/cola drinks
  • Beans
  • Pasta
  • Fiber cereals
  • High-fiber foods  
12 hours before your test
  • Stop eating and drinking (water is allowed). 
  • You may continue to take your usual prescribed medicines with water until 12 hours before the test.

Please bring all prescription medications or a medications list to your appointment.

What to expect the day of testing

Don't eat or drink anything the morning of your test. The exception is drinking a small sip of water with your medications.

It’s important to avoid chewing gum or tobacco, smoking cigarettes or eating other breath mints or candies before or during the test.

If you speak a different language from English, download these handy guides to help you prepare:

Food challenge test

A food challenge test is an accurate way for doctors to confirm if a suspected food allergy truly exists. Because the test involves eating small, increasing amounts of food to determine your body's tolerance to a suspected allergy, we'll be by your side the entire time.

How to prepare for the food challenge

Follow this handy chart for medications you can continue taking and which ones you need to stop taking seven days before your food challenge appointment:

Medications you can continue takingStop taking the following medications

Inhaled steroids:

  • Flovent
  • Advair
  • Pulmicort
  • Symbicort
  • Asmanex
  • Singulair

Inhaled steroid nasal sprays:

  • Flonase
  • Nasonex
  • Rhinocort

Oral antihistamines:

  • Benadryl (diphenhydramine)
  • Zyrtec (cetirizine)
  • Claritin (loratadine)
  • Allegra (fexofenadine)
  • Atarax (hydroxyzine

Antihistamine nasal sprays

  • Astelin
  • Astepro

If you don't see your medication listed above, make sure to read all medication labels carefully. Compare the ingredients list on the back with the above guidelines to learn if they're safe to take before your food challenge, especially over-the-counter medications for allergies, sinuses and colds.

If you have any questions, or if you take any of these medications within seven days of the challenge, please contact your doctor for guidance.

If you use albuterol, Xopenex or any bronchodilator medication more than two times (except before exercise) in the week before the food challenge, please contact your doctor.

What to expect on the day of testing

You'll be with us for several hours during your food challenge, but you won't be able to eat any food other than what you're being tested for. However, you can drink the following clear liquids before your challenge:

  • Popsicles
  • Pulp-free fruit juices
  • Sports drinks
  • Water

We understand that being tested for food allergies might cause you to have reactions that can be scary. But rest assured, we will regularly check your vital signs, breathing, oxygen saturation and skin condition during testing. This will be a collaborative effort since we'll look to you to immediately share any signs or symptoms you experience.

And because we'll have a general idea of the food you're sensitive to, we ask that you bring that food with you to your appointment, along with your auto-injectable epinephrine (EpiPen/Auvi-Q).

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