Food Allergy 2011: State of the Science

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Program Description: Food allergies are difficult for the patient to understand and challenging for the clinician to treat. The CDC has recently reported that the prevalence of reported food allergies increased 18% over the past 10 years in children under 18. In addition, children with food allergies are 2 to 4 times more likely to suffer from asthma and other allergies. Allergic reactions to foods can produce life-threatening anaphylaxis, but have also been associated with other head and neck problems such as Meniere’s disease, migraine headache, chronic rhinitis, and chronic serous otitis media. There is a wide range of symptoms attributed to food allergies, such as nausea, cramping, diarrhea, dermatitis, urticaria, asthma, and joint pain. However, despite the fact that otolaryngologists see a large number of patients with food allergies, diagnosis and treatment strategies still remain controversial. The first part of the miniseminar will focus on the scientific basis of food allergies by taking a critical look at the latest scientific evidence available in the literature. A basic review of the relevant immunology will be provided along with a comparison of IgE-mediated food reactions versus non-IgE-mediated food reactions. The impact that food preparation and food spoiling has on allergic pathways will also be examined. In the second part of the miniseminar, the manifestations of food allergies will be discussed. The recent literature concerning the rise in prevalence of food allergies will be analyzed and the impact of food allergies on the head and neck and airway will be reviewed. We will examine the role of oral tolerance in human evolution and the relationship of failure to achieve oral tolerance on the health of the individual. The next section will be devoted to the current diagnostic modalities available for the diagnosis of food allergies. The use of structured patient-completed surveys to maximize thoroughness and efficiency will be discussed. We will compare the performance and accuracy of the different methods of food allergy testing, including skin and in vitro methods vs. the traditional gold standard of double-blind, placebo-controlled food challenge. The final part of the presentation will be devoted to treatment strategies for food allergies. Traditional methods, such as elimination diets and recognizing emergencies will be reviewed, as well as more cutting-edge techniques, such as oral and sublingual desensitization and genetically modified foods, will also be discussed. Audio-visual materials will be used to help present this information to the audience. Educational Objectives: 1) Analyze the literature comparing different methods for diagnosing food allergy. 2) Evaluate the scientific basis of IgE and non-IgE mediated food allergy. 3) Understand the currently available treatments for food allergy as well as future directions.