One of the most difficult parts of managing Dude's multiple and severe food allergies has been navigating food trials. It’s an experience that comes with equal parts hope and anxiety as we assess whether certain foods might be safely reintroduced into his diet. When you have a child with severe allergies and eosinophilic esophagitis (EoE), food isn’t just fuel—it’s potentially dangerous.
Every year, we go through the process of yearly blood work to assess the levels of allergens in his system. This testing helps guide us on which foods we might be able to trial, with the hope of adding something back into his diet. But with EoE in the picture, it’s not just about blood work—it’s also about endoscopies to check for any internal inflammation triggered by certain foods.
How Do Food Trials Work?
For those unfamiliar with food trials, the process is deliberate and slow, but necessary. Here’s a general overview of how it works for us:
1. Yearly Blood Work:
Each year, Dude undergoes blood testing to measure the levels of different allergens in his body. This information helps guide which foods may be safer to trial, though it’s never a guarantee.
2. One Food at a Time:
Once we have an idea of a potential food to trial, we introduce it slowly. Always one food at a time and always under strict medical supervision. Trials are conducted in a doctor’s office, where Dude is closely monitored for any reactions.
3. Endoscopy to Assess for EoE:
Since Dude also has EoE, an endoscopy is often needed after we introduce a new food. This is to check whether the food is causing inflammation in his esophagus, which could lead to long-term damage if left unchecked. The process has eased somewhat now that he’s older and can better communicate any symptoms, but those early years were especially tough.
Food Trials So Far
We’ve done four food trials so far: garlic, soy, almonds, and one other food I honestly can’t remember at the moment. All of them have gone relatively well—though some with more caution than others.
For example, the soy trial was mostly successful but came with its own caveat. While Dude is able to tolerate processed soy products, like soy lecithin (common in packaged foods), pure soy ended up triggering a reaction. During the last increase of his soy trial, he ended up needing an EpiPen after a reaction. So, while we consider the trial a partial success, it’s clear that soy in its pure form still isn’t safe for him.
The Emotional Rollercoaster of Food Trials
I wish I could say these trials were straightforward, but the reality is that each one is an emotional rollercoaster. The hope that he might finally be able to eat a food that’s been off-limits for so long is immense, but so is the fear that something could go wrong. Food trials are never conducted at home—always in a doctor’s office—and for good reason. The risk of anaphylaxis is always there.
But over time, these trials have also brought a sense of relief. As Dude gets older, his ability to communicate what he’s feeling has made a huge difference. He’s better able to tell us if something doesn’t feel right, which means we can take action more quickly and confidently. Today, Dude’s EoE is in remission, and though his list of safe foods is still relatively short, we’re grateful for each small win.
What’s Next?
For now, we continue to monitor his allergens through yearly testing and consider additional food trials when his allergist thinks it’s appropriate. Though it’s a slow process, we’ve been lucky to have mostly positive outcomes so far. Dude has come a long way, and we’ll keep moving forward, one food trial at a time.
---
Key Takeaways about Food Trials:
Yearly blood work is essential for determining which allergens are still problematic and which foods might be safe to trial.
Food trials are conducted one at a time and always under medical supervision, often involving endoscopies to assess EoE symptoms.
While food trials can bring hope, they also come with the anxiety of potential reactions, including the need for an EpiPen.
FAQs:
Why do food trials have to be done in a doctor's office?
Food trials carry the risk of an allergic reaction, including anaphylaxis. Having them done in a doctor's office ensures that medical treatment can be administered immediately if needed.
What happens if a food trial doesn't go well?
If a food trial doesn’t go well, it may lead to an allergic reaction or a flare-up of EoE symptoms. In such cases, we stop the trial and re-evaluate with Dude’s allergist.
How does EoE affect food trials?
EoE adds an extra layer of complexity to food trials because we also need to monitor internal inflammation. Endoscopies help assess whether a new food is triggering a reaction in his esophagus.
Comments