Open challengereintroduction of normal diet

There may be no need to progress to DBPCFC. The reintroduction of a normal diet should be considered in the patient whose symptoms appear to have been only minimally altered by an adequate elimination diet. If this is then followed by the relapse of symptoms, the patient requires reassessment, reapplication of the elimination diet and probable progression to the DBPCFC. Single-blind challenges, where the investigator is aware whether the consumed food is placebo or active, if negative, are useful. They sometimes enable the clinician to avoid having to proceed to DBPCFC that is more resource-intensive to organise. The positive single-blind challenge should ideally be confirmed by a doubleblind challenge.

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