referral criteria from primary care - food allergy

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
	constipation
	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

Reference:

Last reviewed 03/2020

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