Do you feel bloated and suffer severe nausea when you drink a glass of milk? Does your stomach churn when you eat seafood? One man's food another man's poison - Food intolerance and Food allergies are a perfect ode to this wonderful quote. In spite of their imminent differences both these conditions are generally mistaken to be the same. Read on to find out more about food intolerance, its causes, symptoms and methods of treatment.
Usually this occurs when the digestive system is unable to produce the right quantity of enzymes/chemicals to digest a particular type of food.The reactions can be delayed up to 48 hours or more, or effects can be cumulative. Although not life threatening the effects can have a major impact on working and social life of the individual.
Causes of food intolerance
Enzyme defect: Food is broken down by enzymes, proteins produced by our body needed for the complete digestion of food. Lack or inadequate amount of enzymes causes some of the food (if not all) to remain in larger components unable to pass into the blood stream from the small intestine. This undigested food exerts osmotic effects and draws fluids and salts that are rapidly moving towards the large intestines into the gut. This leads to an elevated level of fluids and salts in the colon. Little wonder that the naturally residing bacteria ferment the undigested food into acids like carbon dioxide, hydrogen and hydrogen sulfide. This manifests as flatulence.
Pharmacological: Food intolerance is likened to the side effects caused by drugs. Here the reactions are to the chemicals found in foods such as caffeine, salicylates, and naturally occurring chemicals like histamines. Another possible cause of food intolerance is to additives in foods that are found in the form of sulfites which are added to processed foods for longer shelf life. They can also be found in fruit drinks and wine.
Interaction with drugs: Combination of certain amine compounds in some foods and medications can lead to food intolerance.
Toxic compounds - A number of foods contain naturally occurring toxic compounds which interfere with the digestive system. For eg: inadequately cooked kidney beans contain compounds called lectins that can cause a toxic effect on the blood and cause food intolerance
Symptoms of food intolerance
Symptoms for food intolerance may be many and varied. Symptoms can come and go and change throughout life. They may not be very harmful but eventually will affect an individual's well being. Some of the common food intolerance symptoms are listed below:
Respiratory: Asthma, rhinitis (nasal allergy), glue ear
Gastrointestinal: Infantile colitis and colic, Crohn's disease, recurrent abdominal pain (especially in children), diarrhea and constipation, Irritable bowel syndrome
Skin: Eczema, urticaria
Nervous system: Headache and migraine, hyperactivity
Heart / circulation: Palpitations (heart rhythm abnormalities)
Musculoskeletal: Unexplained joint pain, some kinds of arthritis, unexplained muscle pain
Psychiatric: Somatisation Disorder, Fatigue and hypersomnia (an inappropriate need for sleep)
Common kinds of food intolerance
- Lactose intolerance results from a deficiency of the enzyme lactase, which is needed to digest the sugar in milk. At least one out of 10 people worldwide shares this deficiency and develops bloating, abdominal pain and often, diarrhea when consuming milk.
- Gluten intolerance is caused by an abnormal immune response to the major protein in wheat barley, rye, and oats. This at times leads to Celiac Disease
- Carbohydrate intolerance hinders overweight people from losing weight
- Alcohol Intolerance is another common example wherein there is a deficiency of an enzyme called aldehyde dehydrogenase, which is needed to break down alcohol. Drinking even small amounts can make susceptible people feel unwell and is very common in Asians
- Fructose Intolerance (HFI) is a rare genetic disorder of fructose metabolism. This occurs due to the deficiency of the enzyme, aldolase B. This enzyme completes the conversion of partially converted fructose (fructose-1-phosphate) into glucose.
- Severe headaches, nausea, numbness, irritable bowel, heart palpitations and disturbed sleep are just some of the symptoms reported by people who are intolerant to the flavor enhancer monosodium glutamate or preservatives (sulfite) used in food. Not only found in Chinese food, MSG (E621) is in many processed foods, especially processed cheese and meats, soups and sauces.
- Intolerance to Yeast is very common. There are a wide variety of symptoms in yeast sensitivity which include headaches, breathing problems, abdominal cramps, skin problems and mood swings.
- Irritable bowel syndrome is also another common kind of food intolerance.
Food intolerance testing
Food log and Elimination diet : During this test, patients keep a record for a few weeks of everything they eat and any symptoms that develop in response to specific foods. This can help narrow the list of foods that may be causing problems. The next step is a defined food elimination diet. This can be an avoidance diet of patient-defined triggers, a 'hypoallergenic' diet for four to six weeks, or a rotation diet, in which new foods are introduced sequentially. If a particular food or food groups is suspected to be the cause, it is confirmed by giving it to the patient look for appearance of symptoms.
Blood Tests: Blood tests are often used as an initial test for celiac disease (celiac sprue), they may also be used to screen for lactose intolerance. The blood tests cannot be depended upon entirely as there is a risk of mixed symptoms. Hence they are usually followed up by endoscopy.
Endoscopy (Small Bowel Biopsy): When checking for celiac disease, gastroenterologists look for patterns of damage in the villi, or small hair like projections in the small intestine.
Breath Test: These tests are usually used to diagnose breath tests. Hydrogen is a byproduct of lactose consumption in people suffering from lactose intolerance. Therefore the test involves taking a baseline sample of the patient's breath, then taking samples over several hours after the patient consumes lactose to see if the concentration rises sharply.
Treatment for food Intolerance
Treatment for food intolerance is based on avoiding or reducing your intake of problem foods and treating symptoms when they arise.
Elimination diet: This involves a series of tests whereby the suspect food is used to identify the 'intolerant' element. It is later introduced gradually again to check for tolerance levels. Finally it is avoided if it is found to be intolerant.
The elimination diet generally recommended is FAILSAFE meaning Free of Additives and Low in Salicylates, Amines and Flavor Enhancers. Please check with your general physician before starting on this diet.
Other factors should also be taken into consideration when treating suspected food intolerance. It is common knowledge that emotions can affect the bowel, and it is important to make sure that, if stress is a factor, its possible influence is recognized. An understanding of the contributory effects of drinking too much tea, coffee, or alcohol may also help in the control of symptoms.