Elimination & Challenge Test for Food Intolerance


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After tests trying to identify your food intolerance, an elimination test is usually the initial step in learning to adjust to your food intolerance. You doctor will give you great details on what the elimination test involves and specific instructions for you to follow. The elimination diet is used mainly as a confirmation test of the suspected food intolerance but can also be used instead of medical treatment for the food intolerance.

The uses of the elimination test:

  • Confirmation test of the food intolerance – it will show whether removing the suspected offending food improved symptoms or not
  • Instead of medical treatment – removing the offending food from your diet and then slowly reintroducing it may improve your tolerance to the food

The elimination test sometimes called the ‘elimination and challenge’ test as after the initial elimination of the suspected culprit food, this food is reintroduced to see whether symptoms present and/or whether you have built up any tolerance to the food. You should never attempt a elimination challenge test without the advice of a dietician and/or doctor. Also, you should discuss with your GP before reintroducing offending foods back into your diet.

An elimination diet should be followed rigidly. If you know of a future social event or occasion that may cause a lapse in the elimination diet then post-pone starting the diet until after the event.

The elimination and challenge diet follows the following steps:

  • Elimination - the offending/suspected food is completely eliminated from your diet – this is usually a minimum of 2 weeks. During this time you should try and prepare foods from scratch to minimise the chance of eating the food unknowingly.
  • You should keep a food diary throughout the entire elimination and challenge diet. You should read food labels with great care to avoid mistakenly eating the eliminated food. This would cause the results of the diet to be useless as they wouldn’t give an accurate representation of your food intolerance.
  • If symptoms improve over the elimination period it is likely that the food you have been eliminating from your diet is the offending food. If symptoms do not improve then another suspected food should be tried.
  • Challenge - if the symptoms do improve you should then do the ‘challenge’ part of the elimination and challenge diet. This is involves eating a small amount of the eliminated food. If symptoms develop this confirms the food as the culprit or the food has been cooked inappropriately. If symptoms do not develop you may have developed a tolerance to the food. If no symptoms develop within 24 hours of eating the eliminated food you should try to eat another portion the next day and see if symptoms are triggered. If symptoms do occur on the second time then you should return to avoiding the food.
  •  A small quantity of the food would be; in the case of lactose intolerance drinking half a cup of cow’s milk would be the challenge.

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