Food intolerance Food intolerance, Food allergy

Approx. 5% of the population (women in relation to men 2:1) suffer from a food allergy. Genetically predisposed patients experience allergic reactions to food ingredients, additives or undesired impurities. Gluten intolerance is genetically determined. The prevalence among the population in Europe is 1:500, while more women than men are affected. Regarding lactose intolerance, a distinction is made between a congenital lactase deficiency and an acquired secondary lactase deficiency. In Europe, approx. 20% of adults are affected by this condition.
Fat intolerance often results from recurrent pancreatitis.

For genetic conditions, preventive measures are nearly impossible. Moreover, we can assume that the large percentage of food allergies and intolerances is also due to the considerable amount of processed foods and convenience foods in our food chain. A healthy diet rich in vegetables and salads is recommended for prevention. All foods should be freshly prepared. Current research is investigating if a treatment with probiotic bacteria during the first months of life could have a positive effect in terms of food allergies.

The impairment of fat digestion, which is usually due to recurrent pancreatitis, may be prevented by avoiding alcoholic beverages (often a trigger for pancreatitis in addition to genetic predisposition).

The symptoms start immediately after the ingestion of corresponding food, in the form of abdominal discomfort (stomach ache), flatulence, colic and diarrhoea. In food intolerance, severe allergic secondary reactions and even anaphylaxis (shock) may also occur.

Lactose and fructose deficiencies are diagnosed using a specific hydrogen (H2) breath test.

In order to detect an impairment of fat digestion, a faecal elastase test is used.

Diagnosing food intolerance is considerably more complex. It is based on an initially hypoallergenic diet (potato/rice diet), with the addition of several food groups and evaluation of reactions. As a screening test (to assess the probability of a disease), the methylhistamine content in urine and the allergy markers histamine and IgE in the blood are examined. Gluten intolerance can be detected by specific laboratory results and endoscopic small intestine biopsy (tissue samples).

Lactose and fructose intolerance are treated by avoiding the corresponding foods. This usually necessitates comprehensive nutritional advice.
In the case of lactose intolerance, the addition of the synthetic lactose-splitting enzyme lactase may be advantageous.
If gluten intolerance, i.e. coeliac disease is present, a gluten-free diet is particularly important, since this is also conducive to preventing cancer. As was stated above, avoiding allergy-inducing agents is essential for patients with food intolerance.
This may prove difficult, especially because convenience foods contain various allergens. In any case, this requires comprehensive nutritional advice. As supportive medication, patients may receive what is referred to as antihistamines, or cortisone in cases of acute and severe shock. In recent times, greater attention has been paid to the intestinal immune system and the gut flora. There are numerous possibilities to influence these, for instance by probiotic bacteria as well as immune modulators.