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Food intolerance is about difficulty digesting a food item, resulting in unpleasant feelings or physical reactions. It may cause symptoms like bloating, abdominal pain, spastic pains for a few hours after food consumption.
It is thought that about 10-20% of the population suffers from food intolerance. Generally, food intolerance is caused by enzymatic defects, and thus body struggles in digesting some food items1.
However, there is a broader definition of food intolerances, too. A broader definition includes other conditions like food allergies and celiac disease. However, it is vital to understand that food allergies and celiac disease have an immune component. Food allergy is about hypersensitivity reaction, and celiac disease is an autoimmune condition2.
Generally, food allergies and celiac disease are more complex issues and may cause different kinds of symptoms.
Signs and Symptoms of Food Intolerance
Food intolerance may cause frequent gastrointestinal issues, but its signs tend to be less severe when compared to other gastrointestinal disorders like infections or food allergies.
Thus, a person prone to food intolerance may develop bloating, tummy pain, diarrhea, gastric discomfort after eating some foods. In some rare cases, people with food intolerances may also develop skin rashes and itching.
Here it is also vital to understand that most signs and symptoms would not develop immediately. Instead, they generally occur after some time and even a few hours after having food.
Is there any test for food intolerances?
Yes, some tests can help diagnose food intolerances. Perhaps the most reliable among them is The Food Inflammation Test. It is a test that measures the inflammatory response of the intestine to more than a hundred food items and food additives. Since more than 90% of food intolerances are towards some well-known foods (like grains, shellfish, seafood, nuts, seeds) and food additives, these tests can help identify the foods causing distress in most cases.
When these tests are combined with other diagnostic methods and history taking, doctors can pinpoint the cause of food intolerance in most cases.
In a small number of cases (less than 10%), doctors may struggle to identify the cause of food intolerances. In such cases, other methods may be used. One such way could be determining the food one cannot tolerate well through trial and error. It means that a person may try excluding some foods from the diet and then see how one feels. For example, one may exclude dairy products for a month or six weeks or any other food item that one suspects is causing food intolerance.
It is vital to diagnose food intolerances in a timely fashion to exclude other more severe conditions. Its symptoms resemble many other common functional gastrointestinal disorders like irritable bowel syndrome, anxiety disorder, lactose intolerance, celiac disease, and food allergy.
Further, we look at two other disease conditions that are often regarded as a part of the food intolerance spectrum of disorders. These two less common issues are food allergies and celiac disease.
Food Intolerance vs. Food Allergies
These two conditions may seem to resemble each other, but they are pretty different. Food allergy is a hyperimmune reaction, and food tolerance does not have an immune component, it is just the inability to digest food due to enzymatic defects.
Allergic reactions are generally quite brisk. It means that symptoms develop within minutes of consuming the food item. In some instances, the response may be severe and almost instant leading to life-threatening reactions like anaphylactic shock.
Additionally, there would be other symptoms of allergy in the case of food allergies like itching, sneezing, wheezing, and skin rashes. Food allergies are more common to some selected foods like peanuts, trees nuts, cow milk, shellfish, eggs, and certain berries.
Unlike food intolerance, food allergy reaction is not dependent on the amount of food consumed. Thus, an allergic reaction to peanuts may occur even on consuming a few nuts. However, a food intolerance reaction only occurs on consuming that food in more substantial amounts.
Here it is vital to understand that food allergies and intolerances may also occur to food additives like MSG, food colors, artificial sweeteners, and much more.
Food Intolerance vs. Celiac Disease
Food intolerance is an inability to digest various food items. On the other hand, Celiac disease is an autoimmune reaction to gluten. Gluten is a kind of protein found in abundance in grains like wheat, rye, and barley.
In the case of celiac disease, a person can generally tolerate other foods quite well. Moreover, in celiac disease, the condition keeps getting worse, and a person starts developing symptoms even with small amounts of gluten. This autoimmune reaction damages the intestinal structure leading to malabsorption syndrome.
However, in celiac disease, a person benefits greatly by excluding wheat from the diet.
Celiac disease is not common, unlike a common belief. However, some people also have an allergy or even gluten intolerance, which is different from celiac disease.
Managing Food Intolerances
As one can understand, food intolerance is a chronic issue but a relatively less severe health disorder. It causes indigestion when one consumes some food in substantial amounts. Thus, one may start by completely excluding that food item from the diet. However, one can gradually reintroduce that food to a diet and learn about the maximum tolerable limit.
Additionally, one should be careful when excluding some foods from the diet, like milk from a child’s diet. Excluding some foods may lead to a greater risk of nutritional deficiencies. Thus, one way could be to consume those foods in small portions and eat them along with digestive enzymes. Else, one may also need to look for alternative sources of those nutrients.
Another way to prevent nutritional deficiencies or treat malnutrition could be consulting a dietitian or using food supplements.
Food intolerances are quite common, and an estimated one-fifth of adults may not tolerate one or another food well. It causes significant abdominal discomfort, pain, bloating, and diarrhea a few hours after consuming certain foods. Food intolerances mainly occur due to enzymatic defects, unlike allergies or celiac diseases which are immunological disorders. Food intolerances are best managed through dietary measures like excluding some foods or limiting their intake.
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- Young E, Stoneham MD, Petruckevitch A, Barton J, Rona R. A population study of food intolerance. The Lancet. 1994;343(8906):1127-1130. doi:10.1016/S0140-6736(94)90234-8
- Zopf Y, Hahn EG, Raithel M, Baenkler HW, Silbermann A. The Differential Diagnosis of Food Intolerance. Dtsch Arztebl Int. 2009;106(21):359-370. doi:10.3238/arztebl.2009.0359