About Food Intolerances

Overview

Food intolerance is when a person has difficulty digesting certain foods. It's important to note that food intolerance is different from a food allergy. While a food allergy involves an immune system reaction to a specific food, food intolerance usually affects the digestive system, not the immune system. Food intolerances are quite common and can be caused by a lack of certain enzymes needed to break down specific foods. They are more common in people with digestive system disorders like irritable bowel syndrome (IBS). Symptoms of food intolerance can include diarrhea, gas, and nausea. To manage food intolerances, it can be helpful to identify which foods are causing symptoms by eliminating them from the diet and then reintroducing them one at a time while monitoring for symptoms.

Types

Some common types of food intolerance include:

• Lactose intolerance: This occurs when the body lacks enough lactase, an enzyme needed to digest lactose, a sugar found in milk.
• Gluten intolerance: Also known as non-celiac gluten sensitivity, this condition is different from celiac disease but can cause similar symptoms.
• Fructose intolerance: Fructose is a sugar present in fruits, some vegetables, and honey. In rare cases, individuals may lack the enzyme needed to properly digest fructose, leading to symptoms such as abdominal pain and bloating.
• Sensitivity to food colorings and preservatives
• Caffeine sensitivity: Caffeine is a common ingredient found in coffee, tea, chocolate, and some soft drinks. People with caffeine sensitivity may experience symptoms like restlessness, rapid heartbeat, insomnia, or digestive discomfort after consuming products containing caffeine.
• Sensitivity to sulfites: Sulfites are compounds commonly found in wine and beer. Some individuals may have an intolerance to sulfites and experience symptoms such as headache, flushing of the skin, or difficulty breathing.
• Sensitivity to monosodium glutamate (MSG): MSG is a flavor enhancer often used in processed foods and certain cuisines. Some people may have an intolerance to MSG and experience symptoms like headache or flushing.
• High fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) foods: These are types of carbohydrates that some individuals have difficulty digesting. Foods high in FODMAPs include legumes (such as beans), certain vegetables (like onions and garlic), and sugar alcohols (found in some sweeteners).

Causes and Risk Factors

The causes of food intolerance may include:

• Enzyme deficiencies: Deficiencies in specific enzymes that are responsible for breaking down certain components in food can contribute to symptoms. For example, lactose intolerance occurs when the body doesn't produce enough lactase, the enzyme needed to digest lactose (the sugar found in milk and dairy products). Without enough lactase, lactose remains undigested and can cause digestive symptoms like bloating, gas, and diarrhea.
• Sensitivity to food additives: These additives can trigger symptoms like headaches, skin rashes, or gastrointestinal issues.

Risk factors for food intolerance include:

• Genetics: Some people may have a genetic predisposition to develop food intolerance. Certain genetic variations can affect how the body processes and reacts to specific foods.
• Age: Food intolerance can develop at any age, but some types of food intolerance are more common in certain age groups. For example, lactose intolerance is more prevalent in adults than in children.
• Poor gut health: The health of the gut microbiome plays a role in food tolerance. Imbalances in gut bacteria or conditions like leaky gut syndrome may increase the risk of developing food intolerance.

If you have concerns about your risk for food intolerance or any other health condition, it is best to consult with your healthcare professional for personalized advice and guidance.

Symptoms

Food intolerance can cause a variety of symptoms, which can vary from person to person. The symptoms can also differ in intensity, ranging from mild to severe. Common symptoms of food intolerance include:

• Bloating
• Excess gas
• Stomach pain
• Diarrhea
• Migraine headaches
• Runny nose
• General feeling of being unwell or under the weather
• Cramping.
• Nausea and vomiting
• Heartburn

Diagnosis

To diagnose food intolerance, there are several examinations, tests, and procedures that may be performed. These include:

• Elimination diet: This involves removing specific foods from your diet to see if your symptoms improve. After a period of time, the eliminated foods are gradually reintroduced to determine if they trigger symptoms.
• Symptom diary: Keeping a detailed record of your symptoms and the foods you eat can help identify patterns and potential triggers.
• Breath tests: These tests can help diagnose lactose intolerance by measuring the amount of hydrogen in your breath after consuming lactose. Breath tests can also be used for other possible carbohydrate (sugar) intolerances, such as fructose or sorbitol intolerance.
• Endoscopy: In some cases, an endoscopy may be performed to examine the gastrointestinal tract for any abnormalities or signs of inflammation.

To determine the specific type of food intolerance suspected, additional examinations, tests, and procedures may be performed. These can vary depending on the suspected intolerance and may include:

• Food challenge test: This involves consuming small amounts of suspected trigger foods under medical supervision to observe any adverse reactions.
• Genetic tests: In some cases, genetic testing may be done to identify specific gene mutations associated with certain types of food intolerances.

Treatment Options

The general goal of treatment is to reduce or eliminate the symptoms of the food intolerance. Treatment options include:

• Nutritional counseling: Nutritional counseling involves working with a healthcare professional, such as a registered dietitian, to develop a personalized diet plan that avoids the intolerant food while ensuring proper nutrition. This can help prevent nutritional deficiencies and support overall health.
• Lifestyle behavior changes: Making lifestyle behavior changes is an important part of managing food intolerance. This may involve avoiding specific foods or ingredients that trigger symptoms, reading food labels carefully, and learning how to identify hidden sources of the intolerant food.
• Enzyme supplementation: For some food intolerances, the deficient enzyme can be taken in a pill form. For example, lactase pills taken before consuming milk products help provide the lactase enzyme that enables a lactase-deficient person to digest milk.

It's important to note that the specific treatment options recommended for food intolerance may vary depending on individual circumstances and the type of intolerance involved. Working with healthcare professionals, such as doctors and dietitians, can help develop a personalized treatment plan that addresses individual needs and goals.

Progression or Complications

Food intolerances can vary from person to person, and the natural progression of food intolerance over time can depend on the specific type of intolerance. Food intolerances typically persist throughout a person's life, as they involve difficulties with digesting certain foods. Symptoms may fluctuate over time and individuals can develop additional intolerances to different types of foods as they get older. It's important for individuals with food intolerances to identify their trigger foods and manage their diet accordingly.

Complications of food intolerance if left untreated or unmanaged:

• Chronic (long-term) gastrointestinal issues/symptoms
• Irritable bowel syndrome (IBS)
• Anemia

It's important to note that while these general patterns are observed in many cases of food intolerance, each individual's experience may vary. It is always best to consult with a healthcare professional for personalized advice and guidance.