Patient information from BMJ

Food allergy: what treatments are available?

Last published:Jan 21, 2022

A food allergy happens when someone’s immune system reacts badly to a specific food. Reactions can vary from mild, such as itching or sneezing, to severe, such as serious heart and breathing problems, which can cause death.

You can use our information to talk to your doctor about the best way to prevent and treat problems caused by food allergies.

What treatments are available?

The treatment you need for an allergic reaction will depend on how severe your symptoms are.

If you are having a severe allergic reaction, or if you are with someone who is, get medical help straight away.

For more background information about food allergy, see our leaflet: Food allergy: what is it?

Mild reactions

For allergic reactions that are not severe, you may just need treatment with allergy medicatines called antihistamines. Or you may just need to make sure you avoid your specific problem food in future.

If your allergic reaction has involved mild breathing problems, your doctor might suggest you use an inhaler for a while, similar to those used by people with asthma, until you can breathe normally again. The medicine in these inhalers helps to open up your airways.

Severe allergic reactions (anaphylaxis)

For a severe reaction (called anaphylaxis) you will probably be given injections of epinephrine, which is another name for adrenaline. You are likely to need several injections at regular intervals until your symptoms improve.

If you have breathing problems caused by swelling in your airway, you might also be given oxygen.

If your airway is severely constricted (narrowed) you might need to be intubated. This means that a tube carrying oxygen is fed through your mouth into your lungs.

Preventing allergic reactions in the future

If you have had a severe allergic reaction caused by a specific food, it could happen again unless you avoid the problem food in future. This means avoiding that food and any foods that have it as an ingredient.

For example, if you are allergic to nuts you need to avoid not just them, but also foods such as cakes, biscuits, and chocolates that contain them, even in small amounts.

Auto-injectors

To try to prevent serious problems, you might be given two epinephrine auto-injectors. These injectors are about the size of a pen. In fact, you may have heard of them being called EpiPens, which is the brand name of one type of auto-injector.

You should carry both of these with you at all times, to use in case you accidentally come into contact with your problem food.

Medical staff will show you how to use the injectors. These injectors go out of date after a while - usually after about 12 to 18 months. Your doctor or nurse will explain how and when to get new ones.

If the injectors are for a child, your doctor should also work with you to make a personalised written emergency plan for what to do if your child has an allergic reaction.

The main thing you need to do is make sure that you (or your child) don’t eat the problem food. For example, you will need to:

• check food labels and restaurant menus to make sure that your problem food is not listed in the ingredients. This is easier than it used to be, as many countries now require food manufacturers and restaurants to list common foods that cause allergic reactions

• ask about ingredients when you are not sure. Restaurants should be able to tell you what is in their food: for example, whether something contains eggs or nuts. If they don’t know and you’re not sure, it’s best to be cautious

• take precautions when preparing food at home. If you are preparing different foods for people with and without allergies, take care to keep ingredients, bowls and plates, and utensils separate.

What to expect in the future

What happens in the future largely depends on how careful you are about preventing repeated problems, and how prepared you are to deal with them.

Of course, sometimes you can just have bad luck. But there are some important things you can do, such as:

• wear medical identification jewellery, such as bracelets, which carry information about you and your allergy. Depending on where you live, you might be able to get this for free. Ask your doctor or local hospital for more information

• if you need auto-injectors, make sure you carry them with you at all times, and replace them when you need to

• pay careful attention to food labels and restaurant menus

• make sure your family is aware of any emergency plans that you have, including using auto-injectors.

Certain groups of people seem to be more likely to have serious and fatal allergic reactions. These include young people and those with asthma. If you or your child is in one of these groups, you should be especially careful.

Allergies and nutrition

Making sure you don’t eat food that you are allergic to can cause problems. For example, by cutting anything that contains your problem food from your diet, you may also be cutting out important nutrients.

It might help to talk to a nutritionist about how to make sure you can eat healthily while avoiding allergic reactions. Ask your doctor about how to get help from a nutritionist.

Allergies into adulthood

While it’s not possible to say what will happen to any one person, many children grow out of their allergies. For example, about 60 in 100 children who are allergic to milk, eggs, soya, and wheat will not be allergic to these things as adults.

But some allergies, such as those to nuts and seafood, are likely to last throughout adulthood.

More help

There are many charities and support groups that offer support to people with allergies of all kinds. For example, in the UK, Allergy UK (allergyuk.org) offers help and information to people with allergies and their families.

Your doctor might be able to help you find a group where you live, or you could easily search online.