ABSTRACT
This chapter discusses the challenge procedures used to confirm and characterize adverse reactions to foods and their interpretation. A single-blind challenge will remove the element of patient bias but will not remove observer bias. The procedure of double-blind, placebo-controlled food challenge was introduced by May in 1976. Food challenges have had various results with regard to patterns of reactions and their timing depending on the patient population examined. It is therefore crucial for the clinician to be aware of these findings in order to interpret the results of a challenge correctly. Repeated food challenges have also been used in this age group in the determination of the natural history of adverse food reactions and as an indicator for a suitable time to reintroduce the food in the diet safely. The diagnosis of adverse reactions to foods using the food challenge procedures requires accurate evaluation of the patient’s history, thoughtful planning of the procedure, and careful administration of the challenge.
