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FOOD ORAL IMMUNOTHERAPY (OIT)

Studies have shown that the OIT process can be done safely and effectively. The number one goal of OIT is safety: to avoid anaphylaxis if the allergic food is accidentally ingested. By reducing the risk of anaphylaxis, patients and their families experience less fear and anxiety over accidental exposures and gain overall improvement in quality of life (eating at restaurants, enjoying birthday parties, traveling, etc.).

 

The first initial day of OIT takes about 5-6 hours in our office. The remainder of the program requires clinic visits every two weeks that will last about an hour and a half. The duration of the program is different for each individual but is typically around nine months.

After you finish the program, you will be required to take a daily maintenance dose.

 

Patients who have a history of anaphylaxis to certain foods AND a positive skin test or blood test are eligible.

Oral Immunotherapy or Oral Induction of Tolerance is a form of desensitization which involves gradually consuming increasing amounts of the food allergen over weeks and months resulting in desensitizing allergic individuals to these foods.

 

Oral Immunotherapy or Oral Induction of Tolerance is a form of desensitization which involves gradually consuming increasing amounts of the food allergen over weeks and months resulting in desensitizing allergic individuals to these foods.

 

FAQS

  • How long will the entire process take?

        The program typically takes about nine months to reach maintenance dosing. The first-day procedure in the office will take             5-6 hours. You will have every other week appointments, which will be about 1 ½ hours.

  • Should routine medications be stopped before the first day of OIT procedure?

        No. Before to starting OIT, we will need to make sure any chronic conditions are well controlled, such as asthma, allergies,            and eczema. Your doctor may suggest you take a daily asthma controller or start immunotherapy or antihistamine                          regimen to help ensure a safe OIT journey. You should continue to take any other routine medications throughout OIT                      unless directed otherwise by your allergist.

  • How often can the dose be increased?

        There must be a minimum of 14 days between dose increases. All dose increases must be done in our office.

  • What is the time frame for home dosing?

         You have a 21-27 hour dosing window. You will need to give the dose at least 21 hours apart but no longer than 27 hours.

  • How long should my child stay awake after a dose?

        Children should be observed for at least one hour after the dose is given. They should not be allowed to sleep during this               time.

  • What about home dosing on the day before the office visit for dose increase?

         There should be at least 21 hours and no more than 27 hours between your last dose and your appointment time. We will             assist you in scheduling your appointments, so it is manageable with your home dosing schedule. NEVER increase the                   dose at home; doing this will result in discharge from the program.

  • Do you allow multiple foods to be done at the same time?

        Yes, we offer multiple foods at the same time when recommended by your physician.

  • Should we do Oral Food Challenges to other nuts or foods prior to starting OIT?

        Your physician will make recommendations on what foods you may qualify to challenge to. The benefit of doing oral food              challenges is that if you fail a challenge, you may be able to do multiple foods simultaneously during OIT.

  • If there is a reaction at home, what should I do?

       You will be given written instructions regarding how to treat reactions.  Education regarding a reaction, including a detailed            emergency action plan, will be provided at your first initial day of treatment. FAI has an emergency on-call nurse and doctor          24/7.

  • What if we are flying when the dose is due?

        Do not administer the dose less than one hour before boarding, and do not administer the dose while flying. If there are                  scheduling conflicts while traveling, please let us know, and we will provide you special dosing instructions. A letter                        explaining the procedure and need for food solution for the Transportation Safety Authority is available on request.

  • Does the food solution need refrigeration?

       There are no preservatives in the food solution. It MUST be kept cold.

  • What if I need additional doses?

        Call as soon as you know you need more solution or doses. We will always supply you with the appropriate amount of                    doses needed for your personalized schedule.

  • What if my child is sick and can’t take the doses on schedule?

         If your child is sick (fever, asthma flare, or other illness), call us before giving any doses. Illness can increase the risk of                 having a reaction.

  • What about masking the taste of the food?

        Taste is personal; experiment. Small volumes could be mixed with a semi-solid food such as apple sauce or pudding.                    However; the entire dose of oral immunotherapy mixture must be taken. If the total amount gets too large, it will be                         difficult to consume all of it. If you are having a difficult time masking the flavor, ask our staff for recommendations.

  • What is the goal of this process?

        The number one goal is safety: to avoid anaphylaxis if the allergenic food is accidentally ingested. The freedom that comes          from OIT is being able to eat foods without reading labels or worrying about cross-contamination.

  • What is the follow-up schedule once graduation has been reached?

        Once you reached maintenance, there should be follow-up at one month and then every six months thereafter.  Labs will be          repeated at the one-month follow-up and yearly.

  • Does my child need to avoid exercise during the oral immunotherapy process?

        Exercise should be avoided for at least two hours after dosing, and doses should not be given immediately following                      exercise. Exercise close to the time of dosing increases the chance of a reaction. Exercise restriction applies to escalation            and maintenance dosing.

  • What is maintenance dosing?

       Once someone is desensitized to a food, they must continue to consume the food to remain desensitized.

  • What is the first step to starting OIT?

        Call us to schedule an OIT consultation with your allergist to discuss treatment options for your food allergy.