Food hypersensitivity in otolaryngology. Manifestations, diagnosis, and treatment

Diet hypersensitivity may be "allergic," that is, caused by some form of immunologic reaction, or nonallergic. The latter includes chemical pharmacologic, enzymatic, or dietary disorders. Food allergies may be immediate Gell and Coombs type I reactions (5%), or delayed "serum sickness" type reactions (95%). The latter type is influenced by frequency of exposure. Any inflammation of the intestinal tract allows abnormal absorption of more allergenic food megamolecules. Manifestations of food allergy seen frequently by the otolaryngologist are legion, afflicting all areas of the discipline's concern. Diagnostic techniques rely on singly or some combination of history taking, challenge testing, and skin testing. The intracutaneous progressive dilution food test is the standardized skin test procedure now taught by the American Academy of Otolaryngic Allergy. Treatment techniques include specific dietary abstinence, a rotary diversified diet, and neutralization immunotherapy.