"Help! My child just went to the allergist. They performed a comprehensive panel of scratch tests and the doctor told me he's positive to tomato, soy, walnuts, pecans, peanut, kiwi, fish, potato, beans, wheat, lettuce and milk. How do I feed him now?!"
Why is it that, despite clear guidance from the AAAAI and other organizations on the limits of these tests, doctors continue to do these treasure hunts?
Dr. Wood, a noted expert in the field, has estimated that up to 60% of "positives" on a SPT are really false positives. Because of this, a skin prick test should be used to confirm an allergy to which there is already a clinical history. Allergies are confirmed by SPT and at least one other piece of evidence: a history of issues when eating the food, a positive RAST test and/or a food challenge.
I'm not excusing all mothers. There are plenty of mothers who shop for an allergist until they find one willing to do this type of shotgun testing because they have anxiety/control issues and actually want to limit what their child eats. There are other mothers who, either intentionally or unintentionally, misunderstand the information their allergist gives them after this type of a test. However, there are enough of these stories floating around the various support groups on the web that you have to wonder: why are the good allergists not policing the bad ones? Why is this type of nonsense testing happening at all? Is it going to take a "Hall of Shame" for doctors to get them to stop?
Bottom line: if your doctor has given you a long list of foods to avoid only on the basis of SPT results, find a new doctor. Don't assume that all allergists know what they are doing when it comes to food allergy testing. Educate yourself and understand what allergy tests can -- and cannot -- tell you.
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My son has Eosinophilic Esophagitis, and my gut reaction based on my own experience, is that kids that gets THAT many food reactions should probably be evaluated for Eosinophilic Diseases. This range of diseases/disorders can occur in any segment of the GI tract, and wreak havoc on the whole thing, and the whole body. My son has zero history of anaphylaxis (but many kids with EGID DO have them in addition to the eosinophilic response) and if he ate a trigger food, he probably wouldn't end up in the ER. He might end up with a belly ache and bad night sleep. But the real damage happens from eating that offending food and over time, scar tissue and stricture occurs. But before that ever happened to my son, he just stopped eating. Need to comment on your awesome new post, the reason I found you...
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