At your initial visit we will do an in-depth review of your medical history, and perform a limited physical exam, with allergy skin testing if indicated. The OIT process will be reviewed, followed by ample time to ask any questions you may have. Some patients may require an in-office oral challenge prior to starting OIT, which will also be discussed at this visit. We do recommend you read the FAQ page on our website prior to your visit.
Your first few visits (each 1 week apart) will be “multi-dose” days, meaning that you will ingest several doses of increasing strengths of your allergen at specific time intervals during your appointment. You can expect to be in the office for about 2-4 hours on these appointment days. You will leave the office on the first day with your doses for the week. Patients will not increase allergen doses at home, as this should always be done in our office under supervision.
**Please note that for patients initiating milk and egg OIT there are 4 multi-dose days instead of 3.
Appointments during these weeks will involve single “up-doses,” meaning that your dose will increase one step from the previous week. You will see your provider at the start of the visit to discuss the previous week's dose(s), and up-dosing adjustments may be made, if necessary. After ingesting your “up-dose” you will be observed in the office for 20 minutes.
Your final dosing day, or oral challenge day, typically occurs around week 20, but this can vary depending on a patient's response during the build-up phase. This is a longer visit, about 2 hours, because the patient is expected to ingest an entire serving of the allergenic food and be observed afterwards.
Finally, we like to take a picture with our “graduate” to celebrate this day and the completion of OIT build-up!
Following the oral challenge visit, patients will go home with a prescribed daily dose of their specific food(s). That dose is likely taken daily for 3 years, at which time we may be able to decrease the frequency of dosing. As time passes and more research is available, recommendations may change to allow for dosing a few days a week instead of daily. However, current recommendations within the food allergy community maintain that daily dosing of allergenic foods is the safest and best way to maintain desensitization.
After the final challenge visit patients will follow-up in the office in 1-2 months, 6 months, and then annually. We may repeat skin and blood tests to monitor the immune system changes we expect OIT to bring about. Additional follow-up visits may be scheduled as needed.