Food Intolerance: Causes and Dietary guidance

Food intolerance, also known as non-Immunoglobulin E(IgE) mediated food hypersensitivity or non-allergic food hypersensitivity, refers to difficulty in digesting certain foods. Food intolerance in children is generally less severe and often limited to digestive problems.

Symptoms 

The following are the most common symptoms of food intolerance:

1. Bloating
2. Migraines
3. Headaches
4. Cough
5. Runny nose
6. Feeling under the weather
7. Stomach ache
8. Irritable bowel
9. Hives

Causes

Food intolerance describes a range of food-related symptoms that are not immunologically-mediated. These account for the majority of food reactions.

1. Functional intolerance – this means an isolated enzyme deficiency
2. Enzymatic defects – this means the inability of the body to digest and absorb a certain nutrient because of the unavailability of a specific enzyme.
3. Transport defects – this mean the inability to transport nutrient molecule into the cells
4. Bacteria overgrowth of the small bowel – Patients who are at risk for bacterial overgrowth include those who have been surgically treated by bowel resection
5. Active compound in foods – Many foods contain compounds with intrinsic biologic activity
6. Idiosyncratic intolerances – Some substances in our foods evoke individual intolerances
7. Structural intolerance – Structural intolerance is due to abnormal structure of the digestive tract

Types

Lactose intolerance

Lactose intolerance is a digestive disorder caused by the inability to digest lactose, the main carbohydrate in dairy products. People with lactose intolerance don’t make enough of the enzyme lactase, which is needed to digest lactose.

Symptoms 

If not managed properly, lactose intolerance can cause severe digestive problems.

The most common symptoms are

1. Bloating
2. Abdominal cramps
3. Gas
4. Diarrhea
5. Nausea 
6. Vomiting 

Dietary advice

1. Avoid dairy products like cow and goat milk and cheese, ice cream, yogurt and butter etc.
2. Avoid food with lactose in them like baked goods, sauce with milk in them, custard etc.
3. Other foods to eat include, plant based milk (almond and rice milk), green leafy vegetables etc.

wheat sensitivity

Wheat Sensitivity or Non-celiac gluten sensitivity (NCGS) implies a specific reactivity to gluten in those who do not have CD but who develop gastrointestinal or extra-gastrointestinal symptoms, immunological, or morphological changes after exposure to dietary gluten. It is possible to no longer be intolerant to wheat by eliminating it from the diet and then reintroducing it later in life.

Symptoms 

Wheat intolerance symptoms do not present themselves immediately. It is thought that they can be delayed for up to 72 hours. The signs of a wheat intolerance may vary in severity and can affect a person both physically and mentally. Typical symptoms of a food intolerance could include:

1. IBS
2. Stomach ache
3. Bloating
4. Headaches
5. Migraines
6. Eczema
7. Acne
8. Itchiness
9. Rashes
10. Tiredness
11. Fatigue
12. Joint pain
13. Anxiety
14. Depression
15. Respiratory complaints

Dietary advice:

1. Avoid foods with wheat or made with wheat flour like baked goods, fried breaded foods, pasta, sauces, semolina etc.
2. Foods without wheat to eat: buckwheat, amaranth, quinoa, oat, corn etc.

Gluten intolerance 

This can cause similar symptoms to celiac disease, but it is a different issue with different long-term effects. Gluten intolerance is an  immune reaction to eating gluten, a protein found in wheat, barley and rye.

Symptoms 

The symptoms may include:

1. Tiredness
2. bloating
3. abdominal pain
4. diarrhea
5. nausea
6. constipation
7. a general feeling of being unwell

The following may also occur:

1. anxiety
2. headaches
3. brain fog
4. confusion
5. numbness
6. joint or muscle pain
7. a skin rash

Dietary advice

1. Avoid any food containing gluten such as foods made from wheat, barley and rye like baked goods, Pastas, semolina-based products, Couscous, some beers etc
2. Other products that may contain gluten includes seasonings, sauces, soups, canned foods, spices
3. Foods without wheat to eat: potato, quinoa, lentis, beans, rice, fruits and vegetables etc.

Other types of  intolerance includes

1. caffeine
2. histamine, present in mushrooms, pickles, and cured food
3. additives such as artificial sweeteners, coloring, or other flavorings etc. 

References 

What is a food intolerance (published by medical news today) https://www.medicalnewstoday.com/articles/263965

Causes of food intolerance (published by news medical life science) https://www.news-medical.net/health/Causes-of-Food-Intolerance.aspx 

Wheat intolerance (published by yorktest) https://www.yorktest.com/intolerance/wheat/ 

Lactose Intolerance 101 – Causes, Symptoms and Treatment (published by healthline) https://www.healthline.com/nutrition/lactose-intolerance-101 

What is gluten intolerance (published by medical news today) https://www.medicalnewstoday.com/articles/312898