The diagnosis of false food allergy is difficult. Amine intolerance, which is frequent in atopic individuals, can eventually be suspected when analyzing the patient's diet. It may coexist with true IgE-mediated reactions. The diagnosis of intolerance to food additives is even more complicated. Besides a thorough clinical history and an analysis of the diet, the first approach is to introduce an additive-free diet, something that is not necessarily simple. Alcohol and coffee, which seem to augment the resorption of small molecular weight substances, should be discarded. Fortunately, additives which are used in small concentrations allow the practice of double-blind oral or sublingual provocation tests in capsules. Three to four concentrations of each substance are usually applied at 2 or 3 day intervals.

Patients who have repeatedly received antibiotics or have a diet particularly rich in sugars and fat might show an invasion of their gastrointestinal tract by Candida albicans or Geotrichum candidum. This infestation seems to favor allergy as well as pseudo-allergic reactions to foods, and should be treated.

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