How is the Elimination Diet Used?

• Hives that occur frequently or linger for months or even years are called chronic urticaria. Treating this condition can be a dodgy proposition. Oral antihistamines may reduce itching, but patients may feel groggy if the medication they use is strong. Occasionally, corticosteroid medications are used (such as prednisone), but because of the serious side effects associated with steroid use, this treatment is usually temporary. One way of treating chronic hives is by putting a patient on an elimination diet, which must be adhered to rigidly. This diet does not limit calories or portion sizes. Rather, it is simply a list of foods, herbs, spices and condiments that are safe to consume (the elimination diet excludes foods generally responsible for causing allergic reactions). If a patient uses the diet and hives go away, foods are reintroduced slowly.
  
  

Elimination Diet Do's and Don't's

• At first glance, the list of foods to avoid on the elimination diet may seem longer than those that are permitted. The diet excludes the obvious culprits--peanut products, dairy, shellfish and food made from soybeans. Meats that are permitted on the elimination diet include saltwater fish, wild game, duck, turkey and organic chicken. Most vegetables may be consumed, however, the diet excludes mushrooms, corn, tomatoes, all types of potatoes, eggplant and peppers (including ground cayenne and paprika).
  
  Fruits and fruit juices can be consumed, with the exception of those from the citrus family, as well as grapes. Bread products can be eaten, as long as they are made from a nongluten substitute, such as brown rice, millet, quinoa, amaranth, teff or buckwheat. Dairy substitutes that are good to go on the elimination diet include rice, almond and coconut milks. While water and herbal teas also can be consumed, the elimination diet forbids alcohol, caffeine and soda. Even refined sugar is on the "do not eat" list; sweeteners permitted include brown rice syrup, Stevia, molasses and fruit juices.
  
  

Elimination Diet Challenges

• The elimination diet is typically used for a month and does give patients with chronic hives a selection of foods that is more than adequate to ensure proper nutrition. Because prepackaged and processed foods cannot be eaten, however, this requires those on the diet to rise to certain challenges.
  
  Dieters must prepare all meals from scratch using the ingredients that are permitted. This may require substantial modifications in their meal plans, as well as revision of existing recipes using substituted food items. While it's possible to make muffins and pancakes with rice flour using fruit juices as a substitute sweetener, this technique may be difficult for someone who's never cooked using substitution methods.
  
  Snackers accustomed to a wide variety of midafternoon treats may find the elimination diet prohibitive; suggested snacks on the diet include rice cakes with cashew butter, sliced vegetables and fruit wedges, sesame rice crackers with tahini and unsweetened fruit juice. Those who are fond of their morning coffee may have a few bad mornings as they adjust their dietary habits to exclude caffeine.
  
  Finally, the diet may challenge the family pocketbook, as many of the food items on the elimination diet, such as organic chicken, fresh fruit and Stevia sweetener, are considerably more expensive than the ground beef, canned fruit cocktail and sugar that would normally be purchased.