Sudden unexpected food allergy - best to try to throw up or not? (do not need answers fast)

Yup. And in general I don’t second guess a doctor who has actually spoken with the patient in person. So I’m dealing with a hypothetical.

As a hypothetical: there are no pills that will help in an actual emergency, even if having some gives you a feeling of being prepared.

The hypothetical IOW as described second hand by the OP, including general allergy symptoms, eye swelling, and asthma symptoms/“light respiratory distress” beginning within a few hours of exposure, would leave me, as someone with some medical knowledge and not easily scared, scared for my wife until it was proven that there was no IgE mediated cause to an ingredient in that dish that she might be exposed to again.

If a doctor told my wife there was no reason for me to be scared and some pills would be enough to be prepared for a future emergency I insist that my wife see someone else.

True, EpiPen use is not indicated for sneezing at a buffet; it is indicated if even past relatively mild IgE mediated reaction is proven and there are any of the symptoms I listed. The next episode may be a fatal one.

Epi is underused. That’s not my opinion. It’s well documented.

Too many incorrectly believe it is not necessarily to use it for the episode, and/or are needlessly scared to use it.

And too many doctors drop the ball:

Criteria BTW:

TABLE I. Clinical criteria for diagnosing anaphylaxis
Anaphylaxis is highly likely when any one of the following 3 criteria are fulfilled:
Sampson et al 393

  1. Acute onset of an illness (minutes to several hours) with involvement of the skin, mucosal tissue, or both (eg, generalized hives, pruritus or flushing, swollen lips-tongue-uvula)
    AND AT LEAST ONE OF THE FOLLOWING
    a. Respiratory compromise (eg, dyspnea, wheeze-bronchospasm, stridor, reduced PEF, hypoxemia)
    b. Reduced BP or associated symptoms of end-organ dysfunction (eg, hypotonia [collapse], syncope, incontinence)
  2. Two or more of the following that occur rapidly after exposure to a likely allergen for that patient (minutes to several hours):
    a. Involvement of the skin-mucosal tissue (eg, generalized hives, itch-flush, swollen lips-tongue-uvula) b. Respiratory compromise (eg, dyspnea, wheeze-bronchospasm, stridor, reduced PEF, hypoxemia)
    c. Reduced BP or associated symptoms (eg, hypotonia [collapse], syncope, incontinence)
    d. Persistent gastrointestinal symptoms (eg, crampy abdominal pain, vomiting)
  3. Reduced BP after exposure to known allergen for that patient (minutes to several hours):
    a. Infants and children: low systolic BP (age specific) or greater than 30% decrease in systolic BP*
    b. Adults: systolic BP of less than 90 mm Hg or greater than 30% decrease from that person’s baseline
    PEF, Peak expiratory flow; BP, blood pressure.
    *Low systolic blood pressure for children is defined as less than 70 mm Hg from 1 month to 1 year, less than (70 mm Hg 1 [2 3 age]) from 1 to 10 years, and less than 90 mm Hg from 11 to 17 years.

Please do not even remotely suggest to anyone that waiting until the need is obvious is appropriate.