The diagnosis of food allergy begins with a detailed history. Food allergy causes reproducible symptoms with every exposure. If this pattern cannot be elicited from the history, food allergy is unlikely. Measurement of specific immunoglobulin E in serum is not useful in the diagnosis of food allergy because asymptomatic sensitisation is common. Oral food challenges are the gold standard of food allergy diagnosis; they should preferably be performed in a double-blind fashion.
Conflict of interest: none declared. Financial support: none declared.