Many people suffer from unpleasant digestive symptoms, such as bloating, abdominal pain, cramps or diarrhoea, which are often caused by some form of food intolerance. In this article, we take a detailed look at the world of food intolerances: we examine the difference between intolerance and allergy, outline the most common types, and offer practical advice on putting together a suitable diet.
An accurate diagnosis and the development of a personalised diet are key to alleviating symptoms. The Endomedix Gastroenterology Centre Our experts will help you identify the underlying causes.
What is the difference between a food intolerance and a food allergy?
Although the symptoms are sometimes similar, the mechanisms underlying the two conditions are completely different.
- Food intolerance: Digestive problem. The body lacks a particular enzyme (e.g. lactase) or has difficulty processing certain substances. The reaction takes place in the digestive system, and the severity of the symptoms often depends on the amount consumed. It is not life-threatening, but it is extremely unpleasant.
- Food allergy: An excessive reaction of the immune system. The body perceives an allergen (e.g. peanuts, milk protein) as a threat and produces antibodies against it. Symptoms can appear immediately, affecting the skin, the airways and the circulatory system, and in the most severe cases can cause life-threatening anaphylactic shock.
Note: From eosinophilic oesophagitis a specific chronic oesophageal condition that lies on the borderline between allergy and intolerance, and is often triggered by food allergens.
The most common types of food intolerances
1. Lactose intolerance
A deficiency of the lactase enzyme, which is responsible for breaking down lactose.
- Symptoms: Bloating, cramps and diarrhoea 30–120 minutes after consuming dairy products.
- Diagnosis: Hydrogen breath test.
- Treatment: A lactose-free diet or lactase enzyme tablets.
2. Fructose malabsorption (fructose intolerance)
Impaired absorption of fructose in the small intestine.
- Symptoms: Abdominal pain, flatulence, diarrhoea.
- Treatment: Avoid foods rich in fructose (honey, apples, pears, cherries).
3. Histamine intolerance
Reduced activity of the DAO enzyme, which is responsible for breaking down histamine.
- Symptoms: Headaches, migraines, redness, a runny nose, digestive problems.
- To be avoided: Mature cheeses, smoked meats, sauerkraut, red wine, tomatoes.
4. FODMAP intolerance
Poor absorption of fermentable carbohydrates (e.g. fructans, polyols). This is one of the main triggers of irritable bowel syndrome (IBS).
- Treatment: A multi-stage low-FODMAP diet (elimination followed by gradual reintroduction).
5. Gluten sensitivity and NCGS
- Coeliac disease: An autoimmune disease in which gluten damages the villi in the gut. It requires a strict, lifelong diet.
- Non-coeliac gluten sensitivity (NCGS): Similar symptoms, but the tests for coeliac disease are negative. Improvement is seen when following a gluten-free diet.
How should we plan a diet for food intolerance?
- Medical examination: Do not attempt to diagnose yourself! See a gastroenterologist to rule out any more serious conditions.
- Food diary: Make a note of exactly what you ate and when the symptoms appeared.
- Elimination diet: Eliminate any suspect foods from your diet for 4–8 weeks, under the supervision of a dietitian.
- Redirection (provocation): Reintroduce foods one at a time, in small quantities, to determine your tolerance level.
Expert advice: Why is it important?
From Endomedix Gastroenterology Centre Its specialists use modern diagnostic procedures (breath tests, endoscopy) and provide dietary advice to help patients avoid developing nutritional deficiencies whilst on a diet.
Summary: Food intolerances can be effectively managed. The first step is a professional assessment, followed by the development of a well-informed, personalised diet plan to ensure a symptom-free life.
