Food Allergy Program

Dr. Sarita Patil of the Allergy and Clinical Immunology Unit discusses food allergies.

Multidisciplinary Expertise Makes the Difference

We take a team approach at the Mass General Food Allergy Program, integrating the expertise of different clinicians to optimally diagnose and treat patients. Depending on symptoms and medical history, the care team may include:

• Allergists
• Gastroenterologists
• Nutritionists
• Psychologists

Having psychologists as part of our team is particularly useful in helping patients manage elimination diets and food aversions. In addition, we can bring in other specialists (e.g. dermatologists, pulmonologists and otolaryngologists) as indicated by your history. We are also happy to coordinate care with your existing care providers.

Care That Spans a Lifetime

Mass General is one of the few academic medical centers in Boston to treat both adults and children with food allergies. This continuum of care is important because while many children outgrow their food allergy, others require lifelong management of their condition. In these cases, consistency of approach is important.

Pediatric patients who remain under our care into adulthood enjoy the comfort that comes from receiving long-term care through a single program. Additionally, we will help coordinate care as patients make transitions to new specialists, such as from a pediatric to an adult gastroenterologist. Learn more about Mass General for Children's dedicated Pediatric Food Allergy Center.

What to Expect

Depending on the disease symptoms, new patients at the Food Allergy Program are seen first by either an allergist or gastroenterologist. The initial evaluation typically entails a detailed medical history, physical examination and blood tests.

When appropriate, we also refer you for skin prick testing or occasionally patch testing and/or a food challenge. In some cases, suspected gastrointestinal allergic disease may be further evaluated by endoscopy. Careful selection and interpretation of these various tests helps us pinpoint which foods may be causing your symptoms.

An important goal of evaluation is first to determine whether a suspected food reaction is indeed due to an allergic reaction. Next, we seek to identify the offending food. Finally, we choose the most effective treatment for you, either avoidance (the most common solution) or medical treatment.

In the case of an avoidance diet, we work with our dieticians to design a solution that provides optimal nutrition. We also offer expert guidance on avoidance of the foods we have identified as problematic, including a detailed treatment plan to manage unintentional exposures.

Based on results of recent studies regarding possible prevention of peanut allergy in children who would otherwise be at risk, we have recently opened a dedicated clinic at Mass General Brigham Healthcare Center (Waltham) once a week focusing on evaluation, management and prevention of peanut allergy in children.

Your entire care team is committed to educating you about your diagnosis and the various aspects of its management, which can be difficult to navigate (especially for children). We believe ongoing patient education is essential to optimizing long-term management of your food allergy. Throughout your relationship with us, we will be completely forthcoming about the limits of what we currently understand and what we believe to be the most promising areas of research.

Recipes for Food Challenges

• Baked milk recipe
• Baked egg recipe

A Commitment to Pioneering Research

Today, treatments for food allergy are largely limited to avoidance. At the Food Allergy Program, we are committed to conducting multidisciplinary research that furthers our understanding of food allergy. As proven new treatments emerge, they will help us provide the best possible care for all our patients.

Upcoming clinical trials at Mass General will explore:

• The role of oral immunotherapy in peanut allergy (for children six to 21 years of age)
• The natural history of eosinophilic esophagitis (EoE) (for adults and children)
• The efficacy of research laboratory tests for predicting allergenic foods in EoE (for adults and children)
• The efficacy of elimination diets in EoE (for adults and children)

Browse online for open trials

About This Program

Diagnosing & Treating Food Allergy

The Mass General Food Allergy Program offers a full range of diagnostic and treatment services for adults and children at the hospital's main campus in Boston, which includes Mass General for Children. Many of our services are also available at Mass General Brigham Healthcare Center (Waltham). Pediatric allergy services are also available at Newton-Wellesley Hospital.

We focus primarily on the diagnosis and treatment of:

• Immunoglobulin E-mediated (IgE-mediated) food allergy: immediate, potentially life-threatening reactions to milk, eggs, peanuts, wheat, soy, tree nuts, fish, shellfish and other foods
• IgE-associated diseases: eosinophilic esophagitis (EoE), gastroenteritis, atopic dermatitis
• Other food antigen-associated diseases: food protein-induced enterocolitis

Certain diagnostic tools (which many hospitals do not have) help our team in making accurate diagnoses, such as:

• Skin patch testing: May be useful for patients with EoE, atopic dermatitis or other diseases that may be caused, in part, by underlying food allergies
• Food challenge: The most definitive procedure for testing whether someone can tolerate a specific food; for safety reasons, can only be performed in a hospital

Treatment for food allergy usually consists of educating the patient on avoiding the foods causing the symptoms, including unintentional exposures.

Dr. Michelle Conroy discusses the role of food challenges in the assessment of food allergy.

An Experienced & Committed Team

Our multidisciplinary team includes allergists and other clinicians who have extensive experience in diagnosing and treating food allergies and incorporate the latest evidence-based research into treatment protocols.

Wayne Shreffler, MD, PhD, director of the Food Allergy Center, joined Mass General in 2009 to help us enhance patient care by:

• Integrating our clinical and research efforts with those of other Mass General specialties
• Expanding our range of patient services
• Launching a robust clinical research program aimed at developing new therapies

Dr. Shreffler did his fellowship training at Mount Sinai Medical Center, which is nationally recognized in food allergy research. He is a member of the Consortium of Food Allergy Research, whose goal is to identify the best possible treatment approaches for food allergies through research.