Food Allergy Management

Question 1

What are the treatment options formanagemen to food allergy

Answer 1

• Appropriate assessment•Allergy focused history and examination.
• Appropriately selected allergy investigations.
• Identify food causing symptoms.
• Dietary advice
• Exclusions–which food/food groups/food formats to avoid.
• Inclusion–which food/groups/formats notto avoid.
• Label reading:Ingredient labeling.Patient Advisory Labels.
• Food reintroductions.
• Medical advice
• Emergency management of allergic/anaphylactic reaction

Question 2

Descrbe the managent fo milk allergy

Answer 2

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Question 3

Describe Lactose evolution and action

Answer 3

Lactase evolution and action
• Detection from 8 weeks gestation; rise from 32 weeks to peak at birth.
• Activity decreases within months.
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• Hydrolysis of lactose into mono- saccharides galactose and glucose

Question 4

What is lactose intolerance

Answer 4

Lactose intolerance (Lactase non-persistence)
• Occurs in most humans; variable.
• Typical symptoms: bloating, flatulence,
explosive diarrhoea.
• Onset subtle; progressive over years.
• Most diagnosed as adolescent or adult.
• Not always symptomatic with milk.

Question 5

What the difference between milk allergy and lactose intolerance

Answer 5

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Question 6

What is the milk ladder

Answer 6

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Question 7

What is anticipatory allergen testingq

Answer 7

Anticipatory allergy testing. At presentation patients are tested for cross-reactive allergens and potential future allergens to minimise dietary exclusions

Question 8

What dietery advice should be given

Answer 8

Dietetic advice for dietary exclusions. Clearly relevant to passive and active management to exclude foods to which the child will have allergic reactions. However, current advice is to avoid only foods that are not tolerated and not classes of foods e.g. one nut rather than all nuts

•Dietary exclusions and inclusions.•Reading labels.•Look for 14 ‘major’ allergens.•Appear in bold.•Managing risk.•Eating out and Take-aways.•‘May contain traces

Question 9

When is emergency medication used

Answer 9

Prescription of emergency medication where indicated eg an epipen

Question 10

Describe early food introductions in infancy

Answer 10

Early food introductions in infancy. This is central to active management where lower allergenic forms of foods e.g. baked milk or baked egg are introduced early as exposure will enhance further tolerance. This is to accelerate tolerance in established allergy. There is evolving evidence that early weaning onto so-called allergenic foods will prevent the development of food allergy.

Question 11

Describe desnsitisation to food allergens

Answer 11

Desensitisation to food allergens. In children with milk and egg allergy that does not resolve as expected, treatment plans are available to attempt to induce tolerance or desensitise these patients and thereby ‘cure’ these allergies. This treatment is also be available for peanut allergy but as yet not widely available for clinical practice.