It is estimated that up to 20% of the world’s population may have a food intolerance. This condition, is however not life threatening like food allergies and causes discomfort when intolerant food is consumed in large amount. This feature discusses the early signs, symptoms and treatment of food intolerance and suggests how can one keep a track of them.
What is food intolerance
It is a gastrointestinal situation when a person is unable to digest a food. However, it is different from a food allergy. People who are intolerant of any food item can consume the food in small quantities but cannot consume the food in larger quantities.
Kirsten Jackson, Lead Dietician at King’s College Hospital London, UAE said “For example, people who are milk intolerant can have milk in their tea and coffee but not large quantities e.g. a glass of milk. This is unlike a food allergy where the individual would need to be 100% free from their trigger food.”
Dr. Huda Kataa, Consultant Gastroenterologist in Mediclinic Dubai Mall said, “It is the difficulty in digesting certain kind of food. It is very common , it may affect up to 20% of the population. It is claimed to affect more than half of the patients who suffer with Irritable Bowel Syndrome. It is different from food allergy when patient’s immune system reacts to even tiny amount of certain food and the reaction is abrupt and can be life threatening , while in food intolerance the severity of symptoms is proportional to the amount of food ingested, the reaction is more delayed and not life threatening.”
Most common food intolerance
Lactose found in dairy items is the most common food intolerance. The list also includes fructose which means inability to absorb sugar found in fruit and honey.
Dr. Huda Kataa of Mediclinic Dubai Mall said, “Additionally, there is intolerance to fermentable carbohydrate found in patients with Irritable Bowel Syndrome, intolerance to Ultra Processed Food (UPFs) which are industrial formulations derived from food and additives to make food more palatable and durable; Celiac disease (Gluten intolerance), None Celiac gluten / wheat intolerance (intolerant to other component in wheat than gluten ). Other food intolerances are seen in migraine (chocolate and strawberry), sulfite sensitivity (alcohol) causing severe attack of asthma.”
Dr. Farah Fiaz, Family Medicine Specialist of HealthBay Polyclinic said, “Lactose which is present in dairy is the commonest intolerance. Other common intolerances are egg, gluten, caffeine, alcohol, fructose, artificial sweetener and salicylate present in lots of different types of food.”
Causes of food intolerance
There can be a number of reasons for food intolerance and can vary from person to person. However, the most common reason is the absence of enzymes which help in digesting foods.
Jasna Kizhakkeveetil, Registered Dietitian at Aster Clinic, Al Qusais said, “Food intolerance can be caused due to the enzyme deficiencies in the stomach that prevent it from breaking down certain compounds in food, a sensitivity to additives and preservatives that are added to natural and packaged foods and an adverse reaction to naturally occurring chemicals in certain foods.”
Early signs of food intolerance
The symptoms of food intolerance begin to show after a few hours of consuming food items in large quantities. Symptoms can vary from person to person. It is advisable to keep a diary if one suspects to be intolerant of certain food items. If symptoms repeat every time, it can be a sign of food intolerance.
Jasna Kizhakkeveetil of Aster Clinic said, “There are a host of symptoms that can identify when you have a food intolerance. Repeated presence of these symptoms when you eat certain food items should be taken seriously, and you should consult your dietitian or gastroenterologist. Some of the symptoms of food intolerance includes nausea, stomach pain, gas, cramps, or bloating, vomiting, diarrhoea, heartburn, irritability or nervousness and headaches.”
How do doctors test for food
While some food intolerances can be diagnosed through tests, others are diagnosed through the elimination process. Doctor keeps track of food consumption and record subsequent reactions of the stomach after every meal. Then, susceptible items are removed from the meals. Then, the same items are introduced one at a time in order to ascertain which particular food was causing symptoms.
Dr. Huda Kataa of Mediclinic said, “Lactose and fructose intolerance can be tested for by a test called Hydrogen Breath Test (HBT): it is a simple test, does not include taking a blood sample. Gluten intolerance (Celiac disease) can be suspected by positive special blood test and confirmed by obtaining a small sample from the small bowel during endoscopy. Diagnosis of Irritable bowel Syndrome basically relies on the symptoms: attacks of abdominal pain followed by change in stool frequency and consistency, however other gastrointestinal diseases can cause similar symptoms, like inflammation of the bowel, celiac disease, lactose intolerance, small intestinal bacterial overgrowth and bowel cancer and your doctor may decide to test for these conditions.”
How can food intolerance be treated
Once the problematic food substance has been identified, the simple situation is to put an end to that particular food’s consumption. Lactose intolerance can be treated by taking the deficient enzyme (lactase) with meals containing dairy product, and patients with irritable bowel syndrome have significant improvement of their symptoms after following low fermentable carbohydrate diet.
Dr. Farah Fiaz of HealthBay Polylinic said, “Once the intolerance has been identified it should be eliminated from the diet under the guidance of your doctor. You should start to feel better within 1-2 weeks, but in some cases it can take longer. If the intolerance isn’t easy to eliminate a dietician can help advice on a diet plan to ensure your nutrition remains balanced. Depending on the severity of the symptoms, under the guidance of a health professional the food can then be slowly reintroduced in small quantities to help build the body’s tolerance to the food.”