[Food allergy--effect of physician attitude on the diagnosis and reported prevalence]

There is great variation in the reported incidence of food allergies, especially the estimated cross allergy to cow's milk and soy.

To assess the attitude of allergists, pediatric gastroenterologists, chief pediatricians and physicians working in the community to cross-sensitivity to cow's milk and soybean. Sesame allergy was used to assess the physician's familiarity with food allergy.

Questionnaires were mailed to 186 physicians of different disciplines. The opinions of primary physicians in the community were assessed according to 171 questionnaires completed at a food allergy conference.

A total of 54% of the allergists estimated that less than 5% of children with cow's milk allergy are allergic to soy, significantly lower than pediatric gastroenterologists and community physicians. On the other hand, only 15% of the pediatric gastroenterologists reported that they encountered patients allergic to sesame, significantly less than allergists (65%) and chief pediatricians (44%). Only half (51%) of the allergists encountered patients allergic to both cow's milk and soy, significantly less than pediatric-gastroenterologists (88%) and chief pediatricians (80%). Although the community physicians felt that the incidence of cross-sensitivity to cow's milk and soy was high, 94% of them were familiar with only a few such patients.

There is significant variability in the attitude and judgment of physicians from different specialties regarding food allergy. It seems that the physician's opinion is influenced by "general knowledge" more than by his own experience. We suggest emphasizing through education that there are two distinct entities of cow's milk intolerance: IgE-mediated allergy and non-IgE-mediated.