By Christian Duffin
GPs are being urged to offer skin prick tests and advise parents to avoid unvalidated allergy tests in the first guidance from NICE on diagnosing and assessing food allergies among children.
NICE says many patients have been avoiding NHS services and relying on alternative tests, but that these may give inaccurate results.
Tests, such as the Vega test - which involves patients putting their hand into a box that measures skin resistance – kinesiology and hair analysis can result in children being put on unnecessarily strict diets and can leave them malnourished, say experts.
NICE recommends that GPs should consider the possibility of food allergy in children and young people with signs or symptoms, such as eczema, vomiting, nausea, constipation, shortness of breath or anaphylaxis.
If a food allergy is suspected, the GP should take an allergy-focused clinical history and offer a skin prick test and/or blood tests for specific lgE antibodies to the suspected foods and likely co-allergens.
Referral to secondary care should be considered if the child has ongoing problems including faltering growth, vomiting, abdominal pain, loose or frequent stools, or constipation, in combination with other gastrointestinal symptoms.
NICE issued the guidance this week after a 2006 Department of Health review concluded that there was considerable variation in current practice for allergy care, with no agreed treatment pathways, referral criteria or service models.
Dr Adam Fox, consultant in paediatric allergy, Guy's and St Thomas' Hospital NHS Foundation Trust, London, who helped develop the guidelines, said: ‘We are seeing more and more children and young people being diagnosed with food allergy in the UK, so this guideline will be absolutely crucial in helping to diagnose and assess this condition, which can be both upsetting and frustrating for both children and their parents.
‘Many parents often turn to alternative methods to help diagnose their child, but there is currently little evidence base for these approaches, and parents often end up putting their children on very extensive restriction diets following the inaccurate diagnosis, which can leave them malnourished, as well as wasting time and money.'
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