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Food Intolerance: Who Doesn’t Need Gluten and lactose

Increased fatigue, skin itching, bloating and pain in the stomach after eating – in the hope that it will “go away”, unpleasant symptoms can be ignored for years. Why the body doesn’t take any healthy food, we sort it out together with doctors: Marina Vershinina, an expert at the Center for Molecular Diagnostics (CMD) of the Central Research Institute of Epidemiology of Rospotrebnadzor, a candidate of medical sciences, a psychotherapist, Mikhail Gavrilov, an author of a method for eating behavior and weight reduction, and an allergist and clinic immunologist “Medicine” by Ekaterina Koroteeva.

How food intolerance is different from allergies
Symptoms of allergies and food intolerances are usually very similar – itching of the skin and mucous membranes, rash, abdominal discomfort, and stool disorders – but their mechanisms are different. An allergic reaction to a product is the body’s immune response to an irritant; while the immune system perceives food proteins as foreign and produces protective antibodies – immunoglobulins E (IgE). The latter provoke an allergic reaction – most often to derivatives of milk, eggs, fish and seafood, wheat protein, nuts or soy. As soon as contact with the allergen ceases, the immune system calms down – and the symptoms of the allergy disappear.

In the case of food intolerance (it is also called “pseudo-allergy”), an overreaction of the immune system does not occur. It is sometimes said that this condition is associated with the production of type G immunoglobulins (IgG), but Marina Vershinina notes that, unlike IgE, allergy markers, class G antibodies are the result of a normal reaction of the immune system, that is, an indicator that the body got acquainted with or other food product and is not going to respond to it. The doctor emphasizes that laboratory tests for the determination of IgG are not cheap, but the detection of such antibodies alone does not allow conclusions to be drawn to sensitivity to certain products.

If a small amount or even one smell of an allergen is sufficient for the appearance of allergy symptoms, then with food intolerance everything is more complicated. In the case of pseudo-allergy, the body’s response is often delayed (sometimes for several days), and the manifestations are blurred. For example, abdominal pain can be accompanied by tiredness or nasal congestion – all this can easily be attributed to overwork or a cold. At the same time, according to the doctor Mikhail Gavrilov, food intolerance is much more common in adults than food allergies. At risk are those who have metabolic problems or diseases of the gastrointestinal tract, as well as smokers and people who move a little.

Where does pseudo-allergy come from
According to Marina Vershinina, a separate disease “food intolerance” does not exist at all – but there are many diseases and conditions against which the intolerance of certain substances in food may appear. This may be due to problems in the production of enzymes that digest one or another component (for example, with a lack of the lactase enzyme, the body does not process lactose, milk sugar). The causes may be inflammation of the intestinal mucosa during infections, and autoimmune processes, and the toxic effect of certain products or drugs. Hypersensitivity to chemical food additives – preservatives, dyes, emulsifiers – is also not uncommon.

Most often, failure occurs due to the fact that certain enzymes are not produced enough. Usually in children this is due to the immaturity of the gastrointestinal tract, and in adults, for example, with inflammation of the pancreas. Lactose intolerance, as a rule, appears already in adults and is considered a normal age process. Whole milk is the basis of nutrition at an early age, but over time, the production of an enzyme that breaks down milk sugar decreases. According to Mikhail Gavrilov, almost a third of people over twenty-five years of age report a deterioration after a glass of whole milk, although they did not have a similar problem before. Fructose intolerance develops due to malabsorption – this breaks down the work of the so-called fructose transporters, that is, the molecules responsible for the passage of a substance through the intestinal wall. Her symptoms – nausea, vomiting, flatulence, diarrhea – resemble poisoning.

How to be treated
According to allergist-immunologist Ekaterina Koroteeva, detecting and curing food intolerance is not an easy task: reliable clinical and laboratory criteria for pseudo-allergy do not yet exist. Therefore, when diagnosing, doctors use the exclusion method, first of all noting an allergy to foods and celiac disease (gluten intolerance, which is based on genetic and autoimmune factors). Confirm lactose intolerance or fructose can help the analysis of stool and breath hydrogen test – it identifies violations of digestion and absorption of carbohydrates, which often lead to bloating and diarrhea; but in this case, the diagnosis will be only preliminary.

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