Your allergy care – what to expectIdentify, treat and protect
Knowing what to expect from your GP or other healthcare professional following an allergic reaction, or suspicion of an allergy, will help to identify what is causing the allergy, treat the symptoms and protect you from future attacks.
This website will take you through the appropriate steps that should be taken to ensure you receive the appropriate information, treatment and management advice from healthcare professionals. This tool will focus on severe immediate onset allergic reactions.
The information provided is based on the recent National Institute for Health and Care Excellence (NICE) Guideline for diagnosis and assessment of food allergy in children and young people in primary care and community settings. Most of the information is also relevant for adults.
1. Top considerations before seeing your GP
Make a list of your symptoms. These may include:
A swollen tongue, hoarse voice, difficulty swallowing, difficult or noisy breathing, wheeze, persistent cough, a dramatic fall in blood pressure, weakness and floppiness, collapse, unconsciousness and a sense of something terrible happening.
There may also be widespread flushing of the skin, nettle rash (otherwise known as hives or urticaria), swelling of the skin (known as angioedema) anywhere on the body, swelling of the lips, abdominal pain, nausea and vomiting. These symptoms can also occur on their own, without the more severe ones. Where that is the case, the reaction is likely to be less serious but you should watch carefully in case any of the more severe symptoms develop.
You would not necessarily experience all of these symptoms in the same episode.
Do you think your symptoms may have been due to a food allergen or to another allergy trigger?
Common food allergens include peanuts, nuts, egg, milk, seafood and soya, but any food could potentially cause symptoms.
Other allergy triggers include bee and wasp stings, certain drugs and medications and latex rubber.
Write down what you had eaten, or been exposed to, prior to your symptoms developing.
If you suspect a food was responsible, was it pre-packed? Bought loose? Eaten in a restaurant?
If possible, get a list of ingredients of any dish that may have been responsible and/or keep the packet if it was pre-packed.
Also make a note of how much food was eaten before the reaction occurred, a tiny mouthful? A serving?
Do you think you have had a reaction to a medicine? If so keep the remaining tablets/medicine and the packaging to show to your GP/Allergy Clinic.
The clinical team can then identify potential allergens used in the ingredients of the medicine, and carry out skin prick testing if appropriate.
Do you have asthma? Is it well controlled?
Asthma can be a risk factor if you have a suspected immediate onset allergy. So it is important the asthma is well controlled, especially while waiting for medical appointments.
Is there a history of allergy or allergic diseases such as asthma, eczema, rhinitis or hay fever in your family?
Your GP may ask you about this to help with a diagnosis.
If you are concerned about your symptoms you should now make an appointment to discuss your concerns with your GP.
Why these are important considerations to ask yourself
There’s no such thing as a mild allergic reaction, they should all be taken seriously. One reaction one day does not mean it will be the same reaction next time.
What is important is to identify the allergy trigger, treat the person as best as possible and protect the person from future reactions.
A severe allergy can lead to anaphylaxis, which in some cases can be fatal.
Anaphylaxis Information Matters and your aim should be to get as much help and information as possible, to empower you to lead a full and active life. You matter.
2. Before your GP appointment
Try to identify what caused you to feel unwell or have a rash.
If you suspect a food is responsible for the reaction make a note of what you have eaten over the previous 24 hours, particularly if it is something you do not eat regularly or if it contains an ingredient you are unsure of.
The questionnaire below will provide you with a with a personalised PDF providing key information that you can you can take to your GP. Please keep your answers short.
3. At the appointment
Your doctor should ask you about any allergies or allergy-related conditions you have already identified, this is called taking an allergy-focused history.
Be proactive. Ask questions. Gain as much information as you can to help you understand the suspected cause and the proposed treatment plan.
Do not be afraid to ask for a referral to a specialist if a severe immediate onset allergy is suspected. Also if you or your child has had a severe immediate allergic reaction, ensure your doctor discusses with you the need to prescribe adrenaline auto-injectors.
Example questions for your GP
I would like to go through my allergy medical history and the allergies in my family, as well as other contributing factors like asthma and eczema (if relevant), so that we can find out if I have an allergy or an intolerance.
If you suspect it is an allergy, what are the next steps?
Will I need a referral to a specialist and how long will that take?
What steps should I take to stay protected in the time between this appointment and the specialist appointment?
What can we do to try to avoid another reaction?
I/my child has had a severe immediate allergic reaction – can you please provide adrenaline auto-injectors?
If I have a reaction again who should I contact/what should I do?
If you think a food may have caused your symptoms ask the doctor if they suspect it is an allergy or an intolerance
There is a difference between an allergy to a specific food and an intolerance to that food. Allergy involves the immune system and can be very serious.
If you have been to A&E after a severe immediate allergic reaction and been prescribed an adrenaline auto-injector ask your doctor on further advice on how and when to administer it.
4. What actions might your GP take if they suspect an allergy?
If you or your child have experienced a severe immediate allergic reaction or any immediate food allergic reaction is suspected and you/your child also has asthma, your GP should:
1. Refer to an allergy specialist for further assessment and testing
2. Prescribe adrenaline in the form of auto-injectors and show you how to use it if a severe immediate reaction has been experienced
The Medicines and Healthcare Products Regulatory Agency (MHRA) and the European Medicines Agency (EMA) both advise that two adrenaline injectors should be available at all times, so ensure your GP has prescribed sufficiently to comply with this.
You may also be prescribed additional medication such as oral antihistamines.
Discuss drawing up a written Allergy Action Plan to help keep you safe in the event of another reaction. You can access the BSACI's Allergy Action Plans for children at risk of anaphylaxis on their website.
If you are being referred, ask how long you’ll have to wait to see a specialist.
You may also be referred if the GP is concerned about any of the following points too -
There is faltering growth in a child in combination with certain gastrointestinal symptoms (e.g. sickness, diarrhoea, tummy cramps).
This could suggest a possible delayed onset food allergy.
You (or your child with the suspected allergy) have not responded to a single food allergen elimination diet.
You/your child have significant atopic eczema and multiple or cross-reactive food allergies are suspected.
"Atopic" means sensitivity to allergens - so atopic eczema often occurs in people who have allergies.
Find out more by reading our Anaphylaxis the Facts factsheet
5. The emotional impact
Experiencing a severe allergic reaction, especially a severe immediate one, can be frightening for the person going through it and those around them. Help is at hand.
It is important to have that essential appointment with your doctor and gain a referral to a specialist IF a potentially severe allergy is suspected.
It is only through a series of tests, which may include skin prick tests, blood tests or dietary elimination trials, that the allergy experts can determine if you have an allergy and what treatment is recommended.
Jacqui suddenly developed her severe allergies as an adult. Here she tells us her story, taking about reaction, diagnosis, coping and management.
Kerry is mum to Caitlin, 10, who has a severe, life threatening allergy to peanuts. The whole family are also members of the Anaphylaxis Campaign. Here, she tells us about the difficulties of bringing up a child with severe allergy and how the Anaphylaxis Campaign can help.
Caitlin (aged 10) has a severe nut allergy. Here she tells us how she manages her allergy with her family's support and what coping strategies work for her.
Anaphylaxis Information Matters. You Matter.
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Many thanks to the following members of the Anaphylaxis Campaign's Clinical and Scientific Panel who clinically reviewed this tool:
Dr Liz Angier, Portfolio GP, Q Member Health Foundation, Clinical Fellow National Leadership Academy; Dr Trevor Brown, Consultant Paediatric Allergist, and Vice Chair of Anaphylaxis Campaign’s Clinical Panel; Dr Andrew Clark, Consultant in Paediatric Allergy and Chair of the Anaphylaxis Campaign’s Clinical Panel; Dr Joanne Walsh, GP, Chair of Primary care group BSACI.