Evaluate and Diagnose Food Reactions

Globally, food allergies (IgE-mediated immune reactions) are increasing in prevalence across ethnicities.1-4 Indeed, the CDC reports that “From 1997 to 2007, the prevalence of reported food allergy increased 18% among children under age 18 years.”

IFM Educator Michael Stone, MD, describes how IFM’s Gastrointestinal Advanced Practice Module frames food allergies and sensitivities:

In most surveys of parents or individuals, the reported rate of food allergy is much, much higher than can be confirmed with an oral food challenge test.1,2 This finding suggests that many of these reactions are not classical IgE-mediated allergies, but instead are food sensitivities. The science behind food sensitivities is unfolding quickly, and IFM wants to help you diagnose and treat your patients who have food reactions. Children and teens may be apprehensive about their food sensitivity, making it vital to help them understand and monitor their sensitivities when not around family.

One study found the presence of objective markers of systemic immune activation and gut epithelial cell damage in patients with non-celiac gluten sensitivity.5 Innate immune activation was increased and intestinal epithelial cell damage observed, which resolved when gluten was avoided.5 When you have a patient with suspected food reactions that could be causing chronic symptoms, but allergy tests are negative, how do you assess them?

IFM’s GI Advanced Practice Module (APM) presents the science and the clinical strategies to understand food allergies, food sensitivities, and related health concerns. Learn how to assess and treat a wide range of gastrointestinal issues, including food sensitivity and many more common but challenging conditions.

Register for the GI APM


  1. Prescott SL, Pawankar R, Allen KJ, et al. A global survey of changing patterns of food allergy burden in children. World Allergy Organ J. 2013;6(1):21. doi:10.1186/1939-4551-6-21.
  2. Hadley C. Food allergies on the rise? Determining the prevalence of food allergies, and how quickly it is increasing, is the first step in tackling the problem. EMBO Rep. 2006;7(11):1080-83. doi:10.1038/sj.embor.7400846.
  3. Sicherer SH, Sampson HA. Food allergy: epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol. 2014;133(2):291-308. doi:10.1016/j.jaci.2013.11.020.
  4. Carrard A, Rizzuti D, Sokollik C. Update on food allergy. Allergy. 2015;70(12):1511-20. doi: 10.1111/all.12780.
  5. Uhde M, Ajamian M, Caio G, et al. Intestinal cell damage and systemic immune activation in individuals reporting sensitivity to wheat in the absence of coeliac disease. Gut. 2016;65(12):1930-37. doi:10.1136/gutjnl-2016-311964.

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