P24 Food reintroduction pattern in children with complex gastrointestinal food allergy

Introduction and Objective Gastrointestinal food allergy (GIFA) is a common condition in paediatric age and both IgE-mediated and non-IgE-mediated reaction are well recognised underlying mechanisms involved in its pathogenesis. Due to the non-specificity of GI symptoms, GI allergic reactions may significantly overlap with a number of other GI disorders, making the diagnosis lengthy and confusing (Heine, 2015). Moreover, in this patient cohort, prolonged food exclusions are common and possibly unnecessary. In our retrospective study, we explore the impact of multidisciplinary team (MDT) approach on the food reintroduction rate in a group of children seen in a tertiary GI allergy service. Method 108 patients (83 new, 25 follow up) were seen between April 2019 and April 2020 in an MDT setting including gastroenterologist, allergist, dietitian, psychologist and clinical nurse specialist. Of those, 32 children with eosinophilic oesophagitis (EoE) alone were excluded. Hence, 76 patients [61%, (n=46) non IgE mediated allergy, 4% (n=3) IgE mediated allergy, 27% (n=20) combined IgE, non-IgE and EoE, 10% (n=7) had other food triggered conditions) were retrospectively reviewed. Results 97% (n=74) of children were following exclusion diets for ≥12 months, with a mean of 5 excluded foods (median 4, IQR 2, 6). At the follow-up, the mean number of foods excluded had reduced to 3 (median 2.5, IQR 1, 5); p Conclusion In children with GIFA, long-term unnecessary food exclusions should be avoided, due to the relationship with poor growth, feeding difficulties and nutritional deficiencies (Meyer, 2018) Despite the fact that the majority of them had been following long-term exclusion diets, over half of patients were able to reintroduce at least one food into their diet. In this cohort, the MDT approach, which brings together professionals from different backgrounds to pave the most effective management plan for the patient, has shown to be highly beneficial in supporting patients and their families to reintroduce foods into their diets. However this requires ongoing support for many families’ in-between medical appointments to achieve this goal. This small centre outcome demonstrates some positive impacts of MDT approach, which should become the standard model of care in children with complex GIFA. References Heine R, 2015. Gastrointestinal Food Allergies. Food Allergy: Molecular Basis and Clinical Practice, pp.171–180. Meyer R, (2018). Nutritional disorders resulting from food allergy in children. Pediatric Allergy and Immunology, 29(7), pp.689–704.