Gastro-Esophageal Reflux Diseases

Food Intolerance

About Food Intolerance

It’s pretty common to have a reaction to a certain food, but in most cases it’s an intolerance rather than a true allergy. Food intolerance is an immune system reaction that occurs soon after eating a certain food. Even a tiny amount of the allergy-causing food can trigger signs and symptoms such as digestive problems, hives or swollen airways. In some people, a food allergy can cause severe symptoms or even a life-threatening reaction known as anaphylaxis.
There is a subtle difference between Food Allergy and Food Intolerance. Food Allergy is a condition that comes suddenly, small amount of food can trigger it, happens every time you eat a particular food and yes, it could be life threatening.
Food Intolerance on the other hand can be gradual, occurs only when you eat substantial quantity and if you eat the type of food often. Intolerance is usually not life-threatening.

Symptoms of Food Intolerance

Both food allergy and intolerance can cause nausea, abdominal pain, bloating ,gas, flatulence, diarrhea or vomiting. For some people it may trigger – tingling sensation or itching in the mouth, Swelling of lips, face, tongue, throat or other parts of the body. They may also trigger hives, itching or eczema. Some may even experience breathing trouble, dizziness, lightheadedness or fainting.

These triggers cause about 90% of food allergies:

  • Peanuts
  • Tree nuts (such as walnuts, pecans and almonds)
  • Fish
  • Shellfish
  • Milk
  • Eggs
  • Soy
  • Wheat

Lactose Intolerance happens when people can’t digest lactose, a sugar found in milk and dairy. Another kind of intolerance is being sensitive to sulfites or other food additives. Sulfites can trigger asthma attacks in some people.
Gluten allergy : While celiac disease — a long-lasting digestive condition that’s triggered by eating gluten — does involve the immune system, it doesn’t cause life-threatening symptoms.

Diagnosis of Food Intolerance

It is not easy to determine whether somebody has a food intolerance or allergy because the signs and symptoms often overlap. Certain patterns in the symptoms can help a doctor distinguish between the two. In the vast majority of cases, food intolerance symptoms take much longer to appear than food allergies.

Patients are advised to keep a diary and write down which foods are eaten, what the symptoms were like, and when they appeared. The data in the diary can help a dietician or doctor identify which foods are causing adverse reactions, and what steps to take. The best diagnostic tool is an exclusion diet, also known as an elimination or diagnostic diet.

The doctor may recommend a breath test/ and/or a blood test to rule out a food allergy:

  • Hydrogen Breath Test – this test determines if the patient is intolerant to lactose or milk . A small quantity of concentrated lactose is given dilutes in milk and periodic breath samples are taken and also  patient’s symptoms are recorded during the test which approximately lasts 3 hours. Patients will be advised to come  fasting after specific instructions prior to the test. The patient may be advised to also undergo a repeat breath test to check for bad bacteria or SIBO.
  • Blood test – this measures levels of IgE (immunoglobulin E) antibodies. These tests are not 100 percent reliable either. The presence of IgE antibodies may be a part of the normal human response and indicate tolerance, rather than an adverse reaction

Treatment of Food Intolerance

Once food allergy has already developed, the best way to prevent an allergic reaction is to know and avoid foods that cause signs and symptoms. For some people, this is a mere inconvenience, but others find it a greater hardship. The challenge is when the ingredients of a food is hidden by the way it is prepared and consumed.

If you know you have a food allergy, follow these steps:

  • Know what you’re eating and drinking.
  • Be careful at restaurants.
  • Plan meals and snacks before leaving home.
  • Talk with your doctor about prescribing emergency epinephrine