Diagnosis of food allergy

Background: Food allergy is gaining substantial interest by both the public and health professionals. It is usually overdiagnosed by the public and misdiagnosed by physicians. Objective: To provide an outline for appropriate evaluation of patients suspected of having food allergy. Data Sources: Information was derived from selected review and original articles published in peer-reviewed journals and from authoritative textbook chapters, supplemented by the clinical experience of the author. Results: Several approaches have been used for food allergy diagnosis, including the medical history, trials of elimination diets, food/symptom diary, skin testing, in vitro tests, and oral challenges. In most cases, the medical history is inconclusive and the reliability of the in vivo and in vitro tests is suboptimal. Appropriately designed challenge testing remains the gold standard, although it has a few limitations. Conclusions: Appropriate selection, application, and interpretation of tests for food allergy are necessary for attaining a high degree of accuracy of diagnosis.