Survey of physicians' approach to food allergy, Part 1: Prevalence and manifestations.

INTRODUCTION

Food allergy (FA) prevalence is increasing and is being popularly claimed by the general population.

OBJECTIVE

To evaluate attitudinal differences between allergists and nonallergists with regard to prevalence, manifestations, offending food component, and time of onset of FA reactions.

METHODS

A 2-page questionnaire was mailed to 3,000 members of the American College of Allergy, Asthma and Immunology and 4,000 nonallergists (1,000 each of internists, pediatricians, family practitioners, and otolaryngologists).

RESULTS

Responses were received from 584 allergists and 77 nonallergists. The overall estimated prevalence of FA was significantly higher for nonallergists than allergists (12.1% vs 4.6%) and in each age group. The most common gastrointestinal manifestation of FA was oropharyngeal itching according to allergists (67.2%) vs diarrhea according to nonallergists (42.5%). More nonallergists than allergists reported neurobehavioral manifestations, musculoskeletal symptoms, and upper airway symptoms as common in FA. On the other hand, more allergists than nonallergists considered atopic dermatitis, acute urticaria or angioedema, and anaphylaxis to be common. Nonallergists considered carbohydrates, fat, and additives as causing allergy much more than allergists did (34.4% vs 6.9%; P < .001). With regard to time of onset of FA, nonallergists had higher estimates than allergists for both late (25.5.% vs 13.0%; P < .001) and delayed (22.1% vs 4.5%; P < .001) reactions.

CONCLUSION

Significant differences in attitudes toward FA were revealed between allergists and nonallergists, which highlights the need to enhance education in this area.