FAQ for Providers

About the Testing

To our knowledge, patch testing has never before been utilized for this purpose. Its use is based on results of clinical studies (Study 1, Study 2)) performed by Michael Stierstorfer, MD, and colleagues.

The foods have been carefully selected over a ten-year period from the medical literature as foods known to cause allergic contact dermatitis (Type 4 allergies) in the skin. The foods are also among those used in the most recent study.  All are safe to eat as normally encountered in the food supply.

IBS-80 Basic tests for allergic reactions to 80 foods that were among the most commonly reactive in the most recent clinical study, accounting for 97.5% of all the reactions. IBS-80 Plus includes all 80 foods in IBS-80 as well as 26 additional foods that were among the least commonly reactive in the same study. These 26 additional foods accounted for 2.5% of the reactions in the latest study.

IBS-80 Plus is recommended since it offers the most comprehensive testing and offers the highest probability of detecting all relevant allergies.

There are several reasons to consider IBS-80 Basic instead for your patient:

  • For most people, Basic will likely identify all relevant allergens.*
  • Practically speaking, in smaller individuals, it is often difficult to find enough surface area on the back (and upper inner arm if necessary) to apply and keep in place more than 80 allergens for 48 hours.
  • There may be financial considerations. (See FAQ page: Does healthcare insurance cover IBS-80?)

*Note:  If allergens are identified by Basic and after one month of avoidance the symptoms persist, it is highly recommended to test the patient for the remaining 26 allergens since one or more of these allergens may also be contributing to the symptoms. Contact us for information about ordering these additional 26 allergens.

Currently, only Basic and Plus are available. However, if you administer Basic and allergens are identified and after one month of avoidance the symptoms persist, it is highly recommended to test the patient for the remaining 26 allergens since one or more of these allergens may also be contributing to the symptoms. Contact us for information about ordering these additional 26 allergens.

If any known food or food additive allergies are reported to you by your patient, list them on the patient’s prescription. If they are among those used in IBS-80 Basic and IBS-80 Plus, they will not be included in the patch test panels during preparation. If the allergies are not disclosed until after the patches are shipped, you may cut out the wells containing the specific foods to which the patient is known to be allergic from the panels. It is easiest to cut out these wells with the plastic backing in place on the patch.

Prick and scratch testing and RAST blood testing search for Type 1 allergies, which involve IgE antibodies and histamine. Type 1 allergies cause conditions such as hives and anaphylaxis and are caused by food allergens such as peanuts and shellfish. These foods typically are different than the foods used for IBS testing that are known to cause Type 4 allergies. Type 1 allergy testing has been studied and is generally believed not to be useful in the evaluation of IBS.

Patients should not participate if they:

  1. are pregnant;
  2. have a severe rash;
  3. have a known severe allergy to adhesive tape;
  4. have received by injection or by mouth any cortisone-containing or other immunosuppressive medications (Prednisone 10 mg or less per day is okay) within the week before the testing or plan on doing so during the testing;
  5. have applied any topical corticosteroids to the back within two weeks prior to testing.
  6. have within 4 weeks of testing received more than minimal sun exposure on the areas of skin to be used for testing.

Note: Antihistamines will not interfere with the testing.

Some insurers cover the testing and others do not. Prior to scheduling, you may use the following codes to check with the patient’s insurer about coverage. For IBS, typically diagnosis code K58.9 (IBS) and procedure code 95044 (patch testing) are used for billing, with the number of units being 80 for IBS-80 Basic and 106 for IBS-80 Plus. Note that many insurance policies limit patch test coverage to 80 units per year.

Order Fulfillment and Logistics

Patches should be applied to the patient within twelve days of receipt by your office. Upon receipt, the patches and liquid allergen-filled syringes should be stored under refrigeration until the morning of use.

Liquid allergens can evaporate within hours, rendering them less allergenic. These allergens are sent in separate syringes and must be applied to the patch test panels within one hour of use on the patient.

A drop of each liquid allergen is needed. Follow the instructions included with the shipment.

The Compounding Pharmacist complies with all Quality Assurance requirements of the Pennsylvania Board of Pharmacisy.

All prescription orders are shipped so that they arrive at your office on either the 2ndor 4thThursday/Friday of each month. The patches should be refrigerated upon receipt and used within 12 days. We must receive your patient-named prescription via fax at least 7 days in advance of these delivery dates. Specify on each prescription which of the two dates the patches should be delivered.

All orders are shipped from The Compounding Pharmacist in West Chester, PA via U.S.P.S. Priority mail, which is included in the price of the product.

Call or e-mail our pharmacy staff for all expedited order requests.