What is food intolerance?
Posted on April 26th, 2015

Dr Hector Perera       London

In food allergy, an abnormal immune system response results in the body making antibodies to ‘fight off’ a food. However, some people suffer symptoms after eating certain foods even when they are not producing antibodies against them.

Food intolerances are more common than food allergies. The symptoms of food intolerance tend to come on more slowly, often many hours after eating the problem food. Typical symptoms include bloating and stomach cramps.

It’s possible to be intolerant to several different foods. This can make it difficult to identify which foods are causing the problem.

Food intolerances can also be difficult to tell apart from other digestive disorders that produce similar symptoms, such as inflammatory bowel disease, gastrointestinal obstructions or irritable bowel syndrome (IBS).

Symptoms of a food allergy 

This is one of the times of the year where people eat all different types of food, either at home or somewhere else. Some call it Sinhala awrudu holidays and some call it Easter holidays. All the schools are also closed for this time so they might go abroad as well for holidays.

May be some people are not used to some kinds of food but they try out or eat them then sometimes problems can develop. The problem that I referring here is about food allergies. Don’t worry it does not happen to everyone but it is possible to cause some problems to some people, may be children or even adults of any age.

The symptoms of a food allergy almost always develop in a few seconds or minutes after eating a particular food or foods.

 Watch out in eating these

The most common allergenic foods, also known as the ‘big eight’, are: Eggs, fish, milk, nuts from trees (including hazelnuts, walnuts, almonds, and Brazil nuts), peanuts (groundnuts), shellfish (including shrimps, mussels, and crab), soya and wheat. No cashew nuts can cause any problems, do they?

Sometimes it isn’t clear which food is causing a problem. The only reliable way of identifying such a food intolerance is through an exclusion diet, where you cut out certain foods from your diet one at a time to see if there’s an effect. Coeliac disease is a common digestive condition where a person has an adverse reaction to gluten. However, coeliac disease is not an allergy or an intolerance to gluten. It is an autoimmune condition where the immune system mistakes substances found inside gluten as a threat to the body and attacks them.

Gluten is a protein found in wheat, rye and barley that damages the intestine of people with coeliac disease. Symptoms include diarrhoea, bloating and weight loss. Coeliac disease can be accurately diagnosed with a blood test and biopsy. About 1 in 100 people in the UK have coeliac disease, but it’s estimated that around half a million aren’t diagnosed.

Turtle eggs

When my dad was working as a medical doctor in Tangalle hospital, we used to eat lot of sea foods such fish and turtle eggs. Even when boiled these turtle egg white hardly turn to hard white stuff as in chicken eggs. The shells are rubbery unlike chicken eggs. I know we eat not more than two chicken eggs but it’s normal to eat more than two or three turtle eggs at a time. I am not sure if those also can cause allergic reactions.

Lactose intolerance Lactose intolerance, sometimes known as dairy intolerance, occurs when your body can’t digest lactose. Lactose is in milk and dairy products such as yoghurts and soft cheeses.

The main symptoms are diarrhoea and stomach pain. In most cases, your doctor can diagnose lactose intolerance by looking at your symptoms and medical history. Sometimes it is good to have tea without milk and drink black coffee after a meal if you are not quite sure.

Treatments for food allergy and food intolerance

In all cases, always read food labels carefully, and learn where your problem food may be used as an ingredient in other foods.

In the case of a food allergy, you’ll have to avoid the food you’re allergic to. You may be able to eat the cooked versions without any problems, as can be the case with fruit or vegetable allergies. That means certain vegetable when eaten in salads or just raw can cause problems.

With lactose intolerance, you’ll have to reduce the amount of dairy food that you eat. With other forms of food intolerance, you’ll have to stop eating the food for a while, or possibly for life. With the autoimmune condition coeliac disease, you must avoid gluten for life.

Symptoms of food allergy

As stated by the National Health Services in England some of the Symptoms include: Tingling or itching in the mouth, a raised, itchy red rash (urticarial) – in some cases, the skin can turn red and itchy, but without a raised rash, swelling of the face, mouth angioedema or other areas of the body, difficulty swallowing, wheezing or shortness of breath, feeling dizzy and lightheaded, feeling sick (nausea) or vomiting, abdominal pain or diarrhoea, hay-fever like symptoms  such as sneezing or itchy eyes allergic conjunctivitis.

 How they get into food

Sometimes the food prepared might have contaminated with stale food or that are gone off. These kinds of food might be from restaurants, hotels and takeaways. The point is once you are there for a holiday, you might go out to various places and often one has to eat out from hotels, restaurants and take away food. If you are not sure to eat or drink a certain kind of food the best thing is to leave it along. Sometimes some foods are under cooked for example beef, lamb, chicken and fish. These under cooked food might have some hidden germs and bacteria and that might trigger these allergic reactions. Sometimes when the vegetables are not washed properly before cooking might have traces of fertilizers trapped in the leaves such as in leeks, cabbage, mukununwenna, tampala and spinach also in carrots, beet and in sweet potatoes. They must be properly peeled and cleaned to avoid these chemicals, fertilizers, sand particles and many more. I think some hotels and restaurants have little or no attention to the cleanliness of cooking. Then in these instances, the innocent customers become the victims.

Have they properly refrigerated?

Who knows if the meats and fish they bring are properly refrigerated before cooking. When they buy bulk, some are left outside the fridges then germs, bacteria either grow on them or get contaminated with dirty equipment and from the floor where they are dropped. Would they properly wash the containers and cooking pans before cooking? The weather conditions are too hot so these germs and bacteria grow on unattended meat products quite quickly.

Chicken to eat chicken

Campylobacter bacteria are the most common cause of food poisoning in the UK, affecting an estimated 280,000 Britons a year – and are to blame for more cases than E.coli, salmonella and listeria put together.

‘Often people don’t report their symptoms, so the true number of cases is likely to be even higher,’ says Bob Martin, a microbiologist and head of food-borne diseases strategy at the FSA.

Around 80 per cent of these cases have been traced to contaminated poultry – it’s thought that two‑thirds of chicken carries the bacteria. Laboratory tests on samples from infected people have found they contain the same campylobacter DNA found specifically in chicken. Other sources of the bacteria include raw meat, unpasteurised milk and untreated water.

Careful in washing chicken because it can spread

When someone washed chicken that droplets of water carrying campylobacter, and other bugs such as salmonella, can splash onto hands, work surfaces, sinks, clothing, cooking equipment such as chopping boards, sponges and cloths – and even other food that isn’t then cooked, such as salad. Would it possible to happen in hotels and restaurant kitchens? I leave it for your imagination.

‘We know the droplets from washing chicken under a kitchen tap can travel up to a metre,’ says Mr Martin. And just a few campylobacter cells are needed to cause disease and food poisoning, adds Dr Laird.

This won’t occur as soon as you’ve eaten the contaminated foods – it can take between one and five days before you start feeling unwell. The symptoms are caused when the bacteria reach the epithelial cells that line the stomach – ‘they have a toxic effect in us which triggers inflammation, and that causes symptoms,’ explains Dr Laird.

In around half of the cases, the illness starts with 24-hour flu-like symptoms. It progresses to profuse diarrhoea that can contain blood, vomiting, abdominal pains and cramps that may resemble appendicitis. Typically, it lasts around a week.

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