Confronting fear and uncertainty: adults’ experiences of undergoing a food challenge test for food allergy

BACKGROUND: Oral food challenges are indicated when food allergies cannot be confirmed by clinical history or investigations, such as blood or skin-prick tests. However, few studies have examined adults' experiences of oral food challenges. METHODS: Semi-structured, individual interviews were conducted with 18 adults who had undergone an oral food challenge at a UK hospital. RESULTS: Three main themes were identified using thematic analysis, describing experiences before, during, and after testing: "A limited and scared life," "facing fear and uncertainty in a safe environment," and "living with revised boundaries." Prior to the test, participants described a life characterized by fear of reactions, hypervigilance, planning and restrictive diets, limiting social participation. During testing, participants experienced an emotional rollercoaster, confronting something previously avoided, which could potentially cause a severe reaction. After testing, participants reported reduced fear and uncertainty following clarification of their allergies, leading to greater freedom, and for those who tested negative, a return to viewing food as a source of pleasure, rather than fear. CONCLUSIONS: Oral food challenges reduce fear and uncertainty surrounding allergies, providing clarity about which foods trigger reactions. Greater availability of oral food challenges would enable adults with suspected allergies to live less restricted and more enjoyable lives.