Food allergy is an adverse immune-mediated response that occurs reproducibly from the ingestion, inhalation, or skin contact with a specific food.

There are three types of food allergy: immunoglobulin E (IgE) mediated, non-IgE mediated, and mixed.1 Food allergy is primarily IgE mediated. Symptoms are immediate and can involve multi-organ systems. This article will focus on IgE-mediated reactions to foods. Allergy can develop to almost any food but common allergens include cow’s milk, eggs, and peanuts, and symptoms usually manifest in childhood.

The GP should consider a diagnosis of food allergy in an individual who repeatedly develops one or more of the following symptoms within minutes and up to 2 hours after exposure to a particular food:2

mucocutaneous — urticaria (wheals or hives), angioedema (swelling of the subcutaneous or submucosal tissue mainly affecting the lips, tongue, and eyelids), erythema, or pruritus;

gastrointestinal — abdominal pain or vomiting;

cardiorespiratory — respiratory distress, wheeze, stridor, hoarse voice, or syncope; and/or

anaphylaxis: severe, potentially life-threatening, multi-system, allergic reaction of rapid onset.

In the UK, up to one in 13 children and one in 50 adults are estimated to have a food allergy.3 Food allergy is increasing in prevalence globally and it can significantly affect the quality of life of patients.

Despite this increasing prevalence, knowledge on how to manage it needs significant improvement, as evidenced by only 33% of primary care clinicians expressing a self-perceived level of knowledge regarded as adequate.4

Food …