Allergy (Food) Challenges & Ladders

A food or allergy challenge is conducted under Medical supervision to see how much of an allergen a patient can be exposed to before an reaction occurs. Usually held in a clinic or hospital environment, the person attends the appointment, which can be up to 3/4 hours depending on out come and is given incremented, gradually increased doses of an allergen they experience reactions to.

This allows specialists to understand several things: the amount of allergen able to be tolerated, the time allotted before a reactions occurs and severity of a reaction.

If the person is able to successfully complete their challenge without a reaction, they are sent home with the precaution to keep an eye out for any delayed reactions, such tummy upsets, hives, Ezcema etc.

If two/three days pass without any reaction symptoms then the person is no longer considered allergic to the allergen and is asked to reintroduce it back into their lifestyle or diet.

This needs to be kept up regularly and exposure is required to be continued several times a week. This is to ensure there is no relapse of a reaction to the allergen.

If a reaction occurs during the challenge itself, the specialists will pause the challenge, administer medication immediately and monitor the patient, ensuring the reaction has resolved before discharge from their care.

Once they are happy the reaction has subsided and it is safe to do so, they will send you home, likely with documents reflective of the reaction and other delayed symptoms to watch for over the next 48 hours.

It is important that someone who has taken part in a challenge is accompanied, does not drive afterwards and has a person to watch for delayed reactions, particularly if reaction previously have been serious.

Patient advice will vary per case, however the suggestion may be to stop and return for another challenge at a later date. Or they may advise to give a tiny amount of allergen to the patient over a prolonged period of time checking back with Medical staff regularly until guided to increased or return.

The Allergy Ladder is a reintroduction tool for allergy sufferers, it allows them to slowly and gradually increase an allergen into their body allowing time for their immune system to respond positively to the allergen. Usually going hand in hand with Challenges, it works on increasing the amount of allergen being reintroduced, while watching for reactions and the bodies response. 

Unlike the Challenge, this is carried out at home and over a prolonged period of time with gradual but regular exposure to the allergen. 

As an example: If on the Milk Ladder, the first step is a biscuit containing powdered milk (this is due to the proteins being broken down in the powdering and then baking processes, allowing for easier digestion), this may be eaten twice a week for a period 6 months. After which the biscuit will become a cupcake, then a muffin, then a pancake, then Cheese, then eventually Milk itself etc.

The ladder works on the premise of having a small amount of exposure over such periods is better than having none at all and assists the body with reducing reactions and giving a tolerance to increased amount over time. Food challenges will be continued in order to monitor the built up tolerance to the allergen in question and going through such process may happily result in a patient passing their challenge.

*Each person's personal health care plan differs and 6 month for one person may not be enough for another person. Always take your specialists advice and guidance in to consideration*