Optimize your response

Treatment Plans

1. Oral Immunotherapy (OIT)

OIT involves administering gradually increasing amounts of the food you are allergic to (allergen) under medical supervision. The goal is to desensitize the immune system, allowing patients to tolerate small amounts of the allergen without severe reactions. Risks include gastrointestinal discomfort, hives, and in rare cases, anaphylaxis. Daily dosing is required, and it’s not suitable for all patients.

for IgE mediated food allergies

2. Biologic Therapy – Omalizumab (Xolair)

Omalizumab is a monoclonal antibody that targets IgE, preventing it from binding to mast cells and basophils, thereby reducing allergic reactions. It is administered via subcutaneous injection every 2–4 weeks. It can be used alone or in combination with OIT to enhance desensitization and reduce adverse effects.

3. Emergency Management

For acute reactions:

Mild to moderate: Oral antihistamines like Benadryl or Zyrtec.
Severe Reactions / Anaphylaxis:
- Intramuscular epinephrine (EpiPen)
- Call emergency services (911)
- Monitor for biphasic reactions

4. Long-Term Management

Avoidance: Complete elimination of trigger foods.
Monitoring: Regular follow-ups, skin prick tests, and IgE blood tests.
Preparedness: Carry antihistamines and epinephrine at all times.

for Non-IgE mediated food allergies

1. Strict Food Avoidance

Eliminate the identified trigger food(s) from the diet for at least 6–12 months
Common triggers include cow’s milk, soy, rice, oats, and eggs
Families are educated on label reading, cross-contact prevention, and hidden sources of allergens

2. Emergency Preparedness

Although anaphylaxis is rare, severe vomiting and dehydration may require emergency care
IV fluids and rehydration are the primary acute treatments
Epinephrine is not typically required, but some mixed IgE/non-IgE cases may warrant its availability

3. Nutritional Support

Dietitians help ensure adequate nutrition despite food restrictions
Formula changes (e.g., switching to extensively hydrolyzed or amino acid-based formulas for infants)
Monitor for growth and development delays

4. Education and Counseling

Provide written materials and emergency action plans (e.g., from the International FPIES Association)
Regular follow-ups to assess symptom resolution and readiness for food reintroduction

5. Reintroduction Strategy

After a period of avoidance, a supervised oral food challenge may be conducted in a hospital setting
If tolerated, gradual reintroduction at home may follow