An allergy focused clinical history (AFCH) is taken to determine whether a food allergy is likely and contains the following types of questions:

  1. Current signs and symptoms, focusing on the skin, gut and respiratory systems
  2. Family history of atopic conditions like asthma , eczema, hayfever in parents and siblings
  3. Relevant diet history from the early years
  4. Dietary history, with the amount and timing of suspected food in relation to the development or progression of symptoms
  5. Assessment of the severity of the reactions – either mild, moderate or severe
  6. Details of previous and current management of condition, including medications or changes in diet
  7. Overall exposure of the suspected food over time
  8. Consider relevance of allergy test or referral to specialist services for further clarification
Diagnostic food exclusion

Food allergy testing is only of value in IgE or immediate reactions to foods, more often involved with skin or respiratory symptoms.  Confirming (or excluding) a diagnosis of food allergy for non-IgE food allergy, most often involving the gastro-intestinal tract, relies on the diagnostic food exclusion.  A strict food exclusion of the suspected food for 2-4 weeks, followed by a planned reintroduction is the next step. Confirmation of diagnosis cannot be made by this method unless relapse of symptoms is experienced with the reintroduction of the suspected food.  This approach is suited to primary care only when non-IgE delayed reactions are present, and not  for the more immediate IgE reactions.