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2288 pages added, reviewed or updated during the last month (last updated: 19/4/2021)

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referral criteria from primary care - food allergy

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Referral to secondary or specialist care

Based on the allergy-focused clinical history, consider referral to secondary or specialist care in any of the following circumstances

The child or young person has:

  • faltering growth in combination with one or more of the gastrointestinal symptoms
    • gastrointestinal
      • IgE-mediated non-IgE-mediated
        angioedema of the lips, tongue and palate gastro-oesophageal reflux disease
        oral pruritus loose or frequent stools
        nausea blood and/or mucus in stools
        colicky abdominal pain abdominal pain
        vomiting infantile colic
        diarrhoea food refusal or aversion
          perianal redness
          pallor and tiredness
          faltering growth in conjunction with at least one or more gastrointestinal symptoms above (with or without significant atopic eczema)

    • or not responded to a single-allergen elimination diet, or

    • had one or more acute systemic reactions, or

    • had one or more severe delayed reactions, or

    • has confirmed IgE-mediated food allergy and concurrent asthma , or

    • has significant atopic eczema where multiple or cross-reactive food allergies are suspected by the parent or carer

Referral for specialist advice is also indicted if either there is:

  • persisting parental suspicion of food allergy (especially in children or young people with difficult or perplexing symptoms) despite a lack of supporting history, or
  • strong clinical suspicion of IgE-mediated food allergy but allergy test results are negative, or
  • clinical suspicion of multiple food allergies


Last reviewed 03/2020