The ten minute consultation: Food allergy
As part of a series of problems common in primary care (see p 1), Aziz Sheikh and Samantha Walker take you through food allergy
A newly qualified teacher requests investigations for possible food allergies. She has been troubled with symptoms of tiredness, nausea, bloating, and intermittent diarrhoea. Bread and chocolate have been identified as possible triggers, and reducing intake of these foods has resulted in some improvement of symptoms. General physical examination is unremarkable.
What does she mean by “food allergy”? Patients often use food allergy as a generic term that encompasses a broad range of symptoms triggered by certain foods. In contrast, clinicians reserve the term for immunologically mediated abnormal reactions to foods. Although about a fifth of the general population believe they have a food allergy, less than 1% of reactions can be confirmed on double blind, placebo controlled food challenge.
Differentiate between IgE mediated allergic reactions and non-allergic food reactions. The former may require meticulous avoidance of the foods implicated (often for life) to minimise the risk of potentially life threatening