Treatments offered

Food allergy

In children, common allergy-provoking foods include cow's milk protein, egg white from hens, wheat, soya bean, codfish and peanuts.

Typically, an immediate type of food allergic reaction involves the immune system. Traces of the offending food rapidly lead to symptoms of generalised rash, itching, body swelling, breathing difficulties and even collapse. Some people with the oral allergy syndrome get a localised red itchy mouth and throat on eating certain fruit, vegetables and nuts – this can be inconvenient but rarely dangerous. Delayed reactions to food are becoming more common and this may be the basis of eczema in some infants.

At Homerton, we diagnose, through skin and blood tests and food challenges, different food allergies and in consultation with our dietitians will produce a management plan to allow children to lead as normal life as possible. We also offer training and support for patients (and their parents/guardians and other care givers - extended family, nursery staff etc) with severe food allergy requiring an adrenalin pen.

Food intolerance

Lactose intolerance, for example, may be caused by the lack of a specific digestive enzyme. Natural histamine may be too rapidly absorbed from food in the diet and effectively lead to a histamine 'rush' that mimics an allergy. Then there are adverse reactions to chemical preservatives and additives in food such as seen with sulphites, benzoates, salicylates, monosodium glutamate, caffeine, aspartame and tartrazine.

Adverse food reactions are of slower onset, do not involve the immune system and aren't usually life threatening. Reactions are usually dose related, with small amounts of the food being tolerated but larger amounts leading to reactions such rashes, flushing, abdominal pain, vomiting, diarrhoea and palpitations. These are by far the most common adverse food reactions seen in general practice.

The lack of a specific enzyme in the body may lead to the build up of toxic by-products and histamine, which then mimic the symptoms of an allergy. This is not true allergy and can be more difficult to diagnose as there are no reliable blood or skin tests available. The suspected food has to be eliminated from the diet and a clinical improvement documented. The offending food should then be reintroduced again for a short period to confirm the adverse reaction and hence the intolerance. IgG blood tests that can be bought in the form of a kit are not recommended.

At Homerton, we try to identify whether a patient has a food allergy or intolerance to a particular food type. Through skin testing, blood testing and food challenges we can help identify certain foods that cause allergy. We also advise on diet plans and food exclusions that won’t compromise your child’s nutritional intake but may help identify an intolerance.

Homerton does not support the use of IgG ELISA blood tests (not to be confused with IgE) as most people develop IgG antibody to the foods they eat - this is a normal response indicating that they have eaten the food, not that they are “sensitive” to the food in question. We have found no convincing evidence that IgG blood test has any allergy diagnostic value

• diagnosis of allergy through exclusion diet trials

• dietary advice following diagnosis of allergy (skin prick testing, blood testing, food challenge)

• dietary advice for food intolerances

• ongoing monitoring and follow-up

• food re-introduction regimes

• advising on nutritional supplements and medication.

Making an appointment

You need to be referred by your GP to access our specialist food allergy clinic.

How to contact us

For general information about allergy:

Andrew Williams
Consultant nurse – allergy
tel: 020 8510 7011

Key staff

Andrew Williams
Consultant nurse – allergy

Dr Rajiv Sood
Consultant paediatrician and allergist

Yvonne Polydorou
Specialist paediatric dietitian

Hester Bair
Specialist paediatric dietitian