How We Can Help

Eczema

This common condition often first appears during infancy, and can cause distressing symptoms including itch and sleep disturbance. Current research suggests that eczema may cause food allergies to develop, and the two conditions often co-exist. Dr Boyle has undertaken several clinical trials to identify ways to prevent eczema from developing, through both dietary and non-dietary interventions during pregnancy and infancy. For a summary of different treatments which have been tested for treating eczema, see the GREAT database held at the University of Nottingham www.greatdatabase.org.uk

Asthma

Up to one fifth of children wheeze during the preschool years on at least one occasion. Children with a tendency to wheeze which persists beyond this time often have allergy to something in the environment such as dust mite, pets or pollens. While most asthma treatments aim to suppress symptoms, allergy-directed treatments focus on avoiding triggers and where appropriate on reducing allergy through desensitisation. Dr Boyle’s research in this area has focussed on environmental control measures and desensitisation.

Food allergy

Food allergy affects 5-8% of infants but is less common in older children and adults. The need for a restricted diet and extra care around activities with food can place a significant burden on families. Allergy testing and interpretation can help clarify which foods need to be avoided, and allow for careful reintroduction of other foods. In children the commonest food allergens are egg, milk, peanut, tree nuts, fish, kiwi fruit, sesame, legumes, soya, wheat and seafood. Dr Boyle’s research has focussed on predicting the risk of future severe allergic reactions for people with food allergy, and prevention of food allergy through dietary and non-dietary measures.

Hayfever

Hayfever is a common condition especially in the second and third decades of life. Triggers include grass pollen, which peaks during June and July in the United Kingdom; silver birch pollen, which peaks during Spring. While avoidance of pollens can be difficult, desensitisation with pollen tablets or pollen drops can be a useful treatment to reduce symptoms in the long term. Dr Boyle leads an allergen desensitisation service in his NHS work.

Insect allergy

Allergy to stings from insects such as wasps and honey bees can cause severe reactions, and is most common in adults rather than children. Most people are stung quite infrequently, but fear of further reactions can have a significant impact on daily activities. Desensitisation with injections of insect venom is a very effective treatment for people at risk of severe allergic reactions. Dr Boyle’s research work contributed to NICE approval of insect venom immunotherapy for treatment people with insect sting allergy in 2012.

Urticaria

Raised itchy rashes and swellings can be very bothersome. This condition is commonly caused by food allergy in young children, but if it keeps recurring or lasts for more than a few hours at a time then it is often so-called ‘spontaneous urticaria’, or one of the ‘physical urticarias’, which are not related to food allergy. For most people, use of a non-sedating antihistamine as required is sufficient to control symptoms, but sometimes testing or other treatments are required.

Anaphylaxis

Anaphylaxis is a severe allergic reaction. Symptoms may include difficulty breathing or lightheadedness due to a fall in blood pressure. Anaphylaxis requires prompt treatment with adrenaline and sometimes other measures. Dr Boyle’s research work has included a clinical trial of different types of adrenaline auto-injector, and work to identify frequency and risk factors for anaphylaxis in people with different allergy problems.

Drug allergy

Approximately one in ten people think they are allergic to a medication, however in most cases this is not the case and the medication can be taken safely. True allergy to a medication can cause severe symptoms however, so a careful and clear diagnosis is helpful in order to avoid unnecessary labelling of drug allergy, and to avoid severe reactions.

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Dr Robert Boyle - MB ChB, MRCPCH, PhD