Pharmacotherapy

Drug treatment is of value in acute allergic reactions, as unintentional ingestion of the food may occur. The need for pharmacotherapy depends on the sensitivity to the allergenic foods and severity of the resulting symptoms. Those who are highly sensitive, for example, to peanut, may react to minute amounts of peanut proteins hidden in the packaged food or food contaminated by peanut during preparation. Despite taking extreme care, total elimination cannot be guaranteed. This leads to significant morbidity and mortality. Early treatment with adrenaline may be life saving.

Drug treatment for patients with chronic food allergy and intolerance is not rewarding. Several drugs have been tried but the results are disappointing. Patients with multiple food allergy or intolerance are at a particular disadvantage, as avoidance is difficult and may lead to nutritional deficiencies. For this reason the diagnosis of food intolerance should only be made after careful consideration of history, immunological tests and preferably double-blind placebo-controlled food challenges (DBPCFCs). The practice of diagnosing food intolerance by unproven and non-scientific methods should be actively discouraged.

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