Practice Nurse

FOOD ALLERGY

Food allergy is an adverse immune response to a food. It can be classified into IgE-mediated and non-IgE-mediated. It may be confused with food intolerance, which is a non-immunological reaction that can be caused by enzyme deficiencies, pharmacological agents and naturally occurring substances. An allergy-focused clinical history will help to determine if a food allergy is likely.

Signs and symptoms of food allergy
IgE-mediated	Non-IgE-mediated
Skin
Pruritus	Pruritis
Erythema	Erythema
Acute urticaria (local or generalised)	Atopic eczema
Acute angioedema (lips, face, eyes)
Gastrointestinal
Angioedema (lips, tongue, palate)	Gastro-oesophageal reflux disease
Oral pruritis	Loose or frequent stools
Nausea	Blood or mucus in stools
Colicky abdominal pain	Abdominal pain
Vomiting	Infantile colic
Diarrhoea	Food refusal or aversion
	Constipation
	Faltering growth + 1 or more GI symptoms
Respiratory system
Upper respiratory tract symptoms (sneezing, rhinorrhea, congestion +/- conjunctivitis
Lower respiratory tract symptoms (cough, chest tightness, wheezing or shortness of breath)
Other
Signs or symptoms of anaphylaxis or other systemic allergic reactions

NICE CG116. Food allergy in under 19s; 2011 (reveiwed 2018). https://www.nice.org.uk/guidance/cg116

Allergy UK Leaflets for patients https://www.allergyuk.org/information-and-advice/conditions-and-symptoms

Milk Allergy in Primary Care (MAP) Guideline 2019. https://www.allergyuk.org/health-professionals/mapguideline

Practice Nurse featured articles

Food allergies - what is the best evidence and approach? Dr Gerry Morrow

Nut allergy in children: a growing concern Celia Proudfoot, Dr Peter Saul

Recognising signs of potential food allergy in children Mandy Galloway

Dealing with emergencies in general practice: anaphylaxis Beverley Bostock-Cox

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