What is an oral food challenge?

Also known as: Food challenge test.

An oral food challenge (OFC) is the gold standard to confirm a food allergy, or to determine if an individual has outgrown an allergy to a particular food. This is generally used in a clinical setting to determine if a patient has lost their allergy to a food.

What happens during the procedure?

Based on history of reaction, skin prick tests, and/or ImmunoCAP blood test, a board certified allergist will determine if it is likely the patient has outgrown their food allergy. If the Allergist decides to proceed with the OFC, the individual with the suspected allergy will schedule an OFC in the Allergist’s office. The day of the appointment, the patient is then given a very small amount of the suspected food. Progressively more of the food is given with each dose, and the individual is monitored very closely for symptoms of an allergic reaction after each dose, and for one hour after the last dose.

Is any special preparation needed?

The patient will need to stop any antihistamine medications for one week prior to the OFC. These challenges are generally done first thing in the morning, and it is best to avoid eating breakfast that day. It is ok to drink clear liquids. 

What are the risk factors?

There is a chance of an allergic reaction to the food. The patient is monitored very closely for any signs of an allergic reaction including rash, hives, swelling, cough, wheezing, nausea, vomiting, and abdominal cramping. If the patient has any of these symptoms, the challenge is stopped and the patient is promptly given medications to reverse these symptoms.

Reviewed by: Amy S Feldman, MD


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