Food Allergies Clinical Presentation

Updated: Feb 05, 2020
  • Author: Scott H Sicherer, MD; Chief Editor: Michael A Kaliner, MD  more...
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History and Physical Examination

Symptoms of food-induced anaphylaxis can include the following:

  • Oropharyngeal pruritus

  • Angioedema (eg, laryngeal edema)

  • Stridor

  • Dysphonia

  • Cough

  • Dyspnea

  • Wheezing

  • Nausea

  • Vomiting

  • Diarrhea

  • Flushing

  • Urticaria

  • Angioedema

  • Ocular injection, ocular pruritus, conjunctival edema, periocular swelling

  • Nasal congestion, nasal pruritus, rhinorrhea, and sneezing

  • Abdominal pain

  • Feeling of impending doom

  • Cardiovascular collapse


Necessary elements of a thorough medical history include the following:

  • Develop a complete list of all foods suspected to cause symptoms

  • Discuss the manner of preparation of the food (cooked, raw, added spices or other ingredients)

  • Determine the minimum quantity of food exposure required to cause the symptoms

  • Determine the reproducibility of symptoms upon exposure to the food

  • Inquire about a personal or family history of other allergic disease

  • Inquire about eliciting factors that can potentiate a food-allergic reaction (eg, exercise [1] , nonsteroidal anti-inflammatory drugs [NSAIDs], or alcohol)

In addition, obtain a thorough description of each reaction, including the following:

  • The route of exposure (ingestion, skin contact, inhalation) and dose

  • The timing of the onset of symptoms in relation to food exposure

  • All observed symptoms and each one’s severity

  • The duration of the reaction

  • The treatment provided and the clinical response to treatment

  • The most recent reaction

Food-associated exercise-induced anaphylaxis describes a disorder in which exercise is tolerated and a food or foods are tolerated, but when exercise follows ingestion of a specific food or foods, anaphylaxis results. [50]

Physical examination

The physical examination findings are most useful for assessing overall nutritional status, growth parameters, and signs of other allergic disease, such as atopic dermatitis, allergic rhinitis, or asthma.

Findings from a comprehensive physical examination can help rule out other conditions that may mimic food allergy.