Food Intolerances and Allergies are a group of conditions were people develop various digestive symptoms after eating certain foods.
Food Intolerance occurs when a patient’s digestive system is unable to break down a certain food. Common intolerant foods include dairy products that contain lactose and wheat products that contain gluten. Inability to break down certain food components could be due to a primary deficiency of enzyme, a progressive loss of enzyme function over time or a loss of enzyme following injury to the gastrointestinal tract.
Food Allergy occurs when a patient’s immune system attacks a specific protein in food. Such a response can be life threatening in some cases. Common allergic foods milk, egg white and peanuts for children and shellfish, tree nuts and peanuts in adults.
In the case of lactose intolerance there are some ethnic groups that appear to be at higher risk including African Americans, Hispanics, American Indians and Asian Americans. Lactose intolerance appears to be least common among Americans of European descent.
Food Intolerances and Allergies are typically diagnosed clinically based on history and physical examination. If there are complicating, alarming or atypical features then you should visit Dr. Mantas for further evaluation and exploration of other more serious gastrointestinal conditions that can mimic Food Intolerances and Allergies. Sometimes additionally testing is needed including blood work, endoscopy and breath tests. Dr. Mantas has specialty training in each of these modalities. In the case of allergies controlled food challenges, skin prick tests, atopic patch tests or radioallergosorbent tests can be ordered under the guidance of an allergist or immunologist to confirm one’s allergy.
People vary in their ability to endure Food Intolerances and Allergies. Some need strict avoidance while others can tolerate small amounts especially when mixed with other tolerable foods.
Symptoms ultimately depend on the type of intolerant/allergic food. In the case of sugars when undigested they pass into the colon where they act as osmotic agents and are fermented by bacteria creating water and gas resulting in symptoms of bloating abdominal pain, diarrhea and flatulence. Symptoms typically occur within a few hours after ingestion.
Acute symptoms may also keep some people from consuming certain foods rich in vital essential nutrients. For example, in the case of lactose intolerance people may become calcium and vitamin D deficient while avoiding dairy products. Therefore, supplementation or eating foods fortified with these deficiencies may be needed.
Avoidance of intolerant/allergic foods is the mainstay of treatment. A gradual reintroduction of these foods at small doses and mixed with other foods may help some people adapt to these foods with fewer symptoms.
Food manufactures have also been able to reduce the amount of intolerant/allergic foods in their product. For example, lactose free milk exists in most major grocery stores. There are also replacement products. For example, almond milk and soy milk taste similar to milk but lacks lactose. There are also some over the counter supplements that can replace the deficient enzyme that is underlying food intolerance. For example, Lactaid® is a chewable tablet that contains lactase.
In cases of secondary intolerances treatment of the underlying condition will alleviate the intolerance. For example, if a patient has lactose intolerance from small intestinal bacterial overgrowth treatment of this condition with antibiotics may alleviate their intolerance. For patients with allergies, novel immunotherapy and genetically engineered foods may be available in the near future.
A variety of other disorders can affect the stomach. Suggestive symptoms include upper abdominal pain, nausea, vomiting, regurgitation, indigestion, heartburn, early satiety and poor appetite. Please visit Dr. Mantas if you feel that you have a gastric disorder. Other common gastric disorders include hiatal hernia, gastroparesis and gastric cancer.