Overview

• Food allergy should be considered as a possibility when chronic GI diseases, such as constipation, and atopic diseases, such as eczema and asthma, have not responded to treatment. // Food allergy should be suspected in any child with eczema, GOR or constipation which has failed to respond as expected.

• Allergy-focused clinical history is recommended prior to undertaking any allergy testing and will guide the suitability of trials of exclusion diets

• Numerous food allergy tests are available to the public but should not be used. These include vega test, biofield resonance scanning, applied kinesiology, hair analysis and serum-specific immunoglobulin G (IgG) antibody testing.

• Referral should be considered when there is persisting parental suspicion despite lack of supporting history.

Resources

• Food allergy in under 19s: assessment and diagnosis (NICE CG 116). 2011.

• Food Allergy (NICE QS118, 2016)

• Diagnosis and assessment of food allergy in children and young people (EKU8, RCGP)

• Allergies (NHS Choices)

• Food allergy - including cow's milk protein allergy (PCDS)​

Cows milk protein allergy

• Non-IgE mediated - children often develop loose stools, abdominal discomfort, eczema and general irritability/colic.

• In IgE mediated: much sooner after ingestion, more severe and can include angioedema or even anaphylaxis.

• Cow’s milk may be a possible food allergen in severe atopic eczema in babies. It is not known for certain whether moderating the mother’s diet is effective, but a 2–6 week trial is recommended.

Resources

• Cows milk protein allergy in children (CKS)

• Guidelines for managing cows mild protein allergy/intolerance in primary care (NHS Lambeth)

Lactose / Wheat intolerance

• Lactose intolerance (NHS Choices)

• Wheat intolerance (NHS Choices)