Diagnostic evaluation.

The diagnosis and management of adverse food reactions is a challenge for pediatricians and other primary care providers. Children of all ages may present with a variety of symptoms that parents have attributed to constituents of the diet. An approach has been devised to aid pediatricians in the evaluation of these children. The process begins with a detailed history. This history may be used to classify the problem into categories of symptoms and possible mechanisms. When common food offenders are suspected of causing symptoms, it is reasonable to obtain in vitro tests that may then be used to decide whether elimination of certain foods is indicated and whether a referral to an allergist is needed. Using this approach, the physician may be able to identify children who are experiencing food-allergic symptoms and aid frustrated families in dealing with problems that have not had apparent solutions. The application of specific testing and the assessment of the results are discussed. Also reviewed are the techniques used by allergists so that pediatricians may help families understand procedures that will be recommended and performed.