Oral Challenges

Depending on ongoing allergy investigations such as skin prick testing and blood work, an oral challenge may be indicated to rule out allergy. This challenge can take anywhere between 3-4 hours onward where small amounts of the suspected allergen will be given in increasing doses during predetermined intervals. At our office, we conduct oral challenges to both foods and medications. Some foods/medications will be provided at the office for a fee ($30-40) while others must be brought by the patient or purchased at a compounding pharmacy.

Please note that some foods (e.g. milk and eggs) will require two oral challenges (one in a “baked” format and one in a “raw/lightly-cooked” format) in order to be deemed no longer allergic. These challenges must be on separate days and the “baked” challenge must be completed before proceeding to the “raw/lightly-cooked” challenge. Please contact our office if you have any questions.

In order to prepare for the upcoming oral challenge:

1. Health: You need to be well. No cough, cold, fever, flu, diarrhea or vomiting symptoms. In the days leading up to the challenge, please notify our office if you are on any new medications or if you do not feel well, even with a mild infectious illnesses, in order for a decision to be made whether the challenge will continue. Please contact our office to reschedule if you are sick.

Your health will be assessed by our staff the day of the oral challenge. Your vital signs, weight, and possibly lung function will be taken.

2. Allergy Medications: Stop all antihistamines, over the counter cough, cold, or flu medications (including Gravol) for five (5) full days prior to the visit. Skin testing is repeated on the day of the oral challenge (if not done in the last month) to assess any change in allergy status to the suspected allergen.

3. Regular Medications: Asthma puffers, allergy nasal steroid sprays, eczema creams, and all other medications may be continued (unless otherwise directed by our office).

4. Time: The oral challenge appointment will be between 3-4 hours, however, as we do not want any anxiety surrounding the appointment, please plan to spend a good portion of the day with us, as challenges may sometimes take longer.

We ask that you bring drinks, snacks and activities with you to the appointment as once the challenge begins, you will be unable to leave the office until the challenge is complete. For infants, please ensure that you bring an extra set of clothing, diapers, and other essentials. For your convenience, we do have wireless service available in the office, so you are welcome to bring your laptop.

**Due to limited spacing, we ask that only one adult accompany you to this appointment.**

5. Blood Work: If blood work was requested, please ensure it is completed and that our office has been contacted for the results at least 48 hours prior to the oral challenge. Blood work can be done at either a Gamma-Dynacare or at a LifeLabs in the community. The lab may charge a fee for these tests, ranging from $22-40 per test.

6. FPIES: For food protein-induced enterocolitis (FPIES) oral challenges, please anticipate being at the office for longer than the time interval mentioned above so that you can be monitored for delayed reactions. For children undergoing an FPIES oral challenge, please ensure that a change of clothes is brought to the appointment.

7. Payment: We accept cash, VISA, MasterCard, or Interac as payment.

8. Consent Form: Find the the consent form for the oral challenge here. A paper copy will be provided to you to sign before the challenge begins.