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This review focuses on advances and updates in the epidemiology, pathogenesis, diagnosis, and treatment of food allergy over the past 3 years since our last comprehensive review. On the basis of numerous studies, food allergy likely affects nearly 5% of adults and 8% of children, with growing evidence of an increase in prevalence. ...

The diagnosis and management of food allergy also may vary from one clinical practice setting to another. Finally, because patients frequently confuse nonallergic food reactions, such as food intolerance, with food allergies, there is an unfounded belief among the public that food allergy prevalence is higher than it truly is. ...The Guidelines include a consensus definition for food allergy, discuss comorbid conditions often associated with food allergy, and focus on both IgE-mediated and non-IgE-mediated reactions to food. ...

Food allergies are on the rise, for reasons that are not fully understood. However, there is a tendency to overestimate their frequency, mostly based on parents' reports or on the assumption that a positive skin or blood IgE test implies the existence of clinically relevant allergy. It is imperative to base food allergy diagnosis on well-defined criteria, avoiding "alternative" tests that are available to the general public. ...

Hippocrates is often credited with first recognizing that food could be responsible for adverse symptoms and even death in some individuals, but it was not until the seminal observations by Prausnitz that the investigation of food allergy was viewed on a more scientific basis. ...With May's introduction of the double-blind placebo-controlled oral food challenge, the study of food allergy became evidence-based and exponential strides have been made over the past four decades in the study of basic immunopathogenic mechanisms and natural history, and the diagnosis and management of food allergies. ...

Due to the fact that the spectrum of the symptoms of the type I food hypersensitivity can include potentially life-threatening reactions, diagnosis is often limited to in vitro assays. ...Atopy patch tests are valuable diagnostic tool in suspected type IV food hypersensitivity, but due to the lack of standardization they are not used routinely. ...

Food allergy arises from a specific immune response induced by food exposure. It is the first cause of anaphylaxis in childhood. ...The treatment is based on the correct avoidance of responsible food (considering hidden allergens), besides patient and their care giver's education, to maintain a good quality of life....

RECENT FINDINGS: Preventing food allergy has been studied for years with questions of whether avoidance or exposure was a better strategy. ...SUMMARY: Providers who see children with food allergies should be aware of the newer recommendations of preventing peanut allergy and the emerging therapies for children with immunoglobulin E-mediated food allergy....

The diagnosis of NCGS/NCWS requires a symptomatic reaction to gluten, or wheat-containing food, and remission of symptoms with gluten or wheat challenge, in patients in whom celiac disease and wheat allergy have been excluded. ...

PURPOSE OF REVIEW: The purpose of this review is to update what is currently known about the major non-IgE-mediated food allergies: food protein-induced enterocolitis syndrome (FPIES), food protein-induced allergic proctocolitis (FPIAP), and food protein-induced enteropathy (FPE). ...Due to the risk of nutritional deficiencies with food avoidance in both infant and maternal diets if breastfeeding, confirmation of diagnosis with challenges is encouraged. ...