Food Intolerance Symptoms in Adults (Lactose, Gluten, Histamine)

What is food intolerance?

In fact, it could be simple: we chew something that we like, the food slides down the esophagus, it reaches the stomach and the intestine, and then it finds its way out.

Yes, that’s easy. However, often it is not.

That is because many disturbances may occur in the digestive tract: sometimes enzymes don’t work properly, as in the case of lactose intolerance, which leads to bloating, diarrhea, and nausea.

People who suffer from fructose malabsorption have abdominal cramps every time they eat it. And those who can not tolerate gluten or histamine are forced to give up certain foods.

Currently, a growing number of patients are diagnosed with various intolerances, and one explanation is that the symptoms are better known today than they were a few years ago. The modern diet also plays an important role in this respect.

Thus, some new varieties of fruits contain a larger amount of fructose, a substance to which an average of one out of three adults reacts with intestinal disorders.

Such inconveniences are annoying, but usually harmless, unlike food allergies, which occur more rarely, but they are much more dangerous. It affects four to eight percent of Europe’s population.

The enemy is the hidden allergens in a wide range of foods. Often, a few pieces of peanuts or traces of eggs are enough to trigger a response from the immune system: at that moment, membranes swell, preventing the breathing to continue normally, and in extreme cases, blood circulation collapses.

The number of allergic people has registered an increase in recent decades. The causes are complex and not fully elucidated yet. But it is obvious that the eating habits of the contemporary man are at least partly to blame.

What can be helpful in these situations is knowing allergens and the appropriate therapies.


How does it arise?

The problems are caused by the sugar (lactose) contained in milk, which is also found in cheese, sour cream, and whipped cream. In order to digest it, the body produces an enzyme called lactase. It works in the small intestine, breaking down sugar into its components, so that it becomes digestible. Patients with this type of intolerance either don’t produce enough lactase or this enzyme lacks completely.

Therefore, lactose is moving along with the mixture resulting from partial digestion of the food in the deeper intestinal segments, where bacteria take over and metabolize it. Finally, these processes lead to the formation of hydrogen, carbon dioxide, and short-chain fatty acids.

Which are the disorders?

Those affected complain of abdominal pain and bloating. Responsible for this is the bacteria in the gut, which feed with excess lactose, producing carbon dioxide. The volume of gas will be directly proportional to the amount of lactose they consume. Symptoms include diarrhea, nausea, and feeling too full. Although less typical, heartburn, fatigue, and migraine attacks are also possible.

How to determine?

It is determined by the hydrogen breath test. The patient is given to drink a solution of lactose dissolved in water, after which the doctor measures the concentration of hydrogen in the breath. The value obtained indicates the activity degree in the gut of bacteria that degrade lactose.

What helps?

In order to improve symptoms, patients are forced to minimize the consumption of milk sugar. Consequently, many of them give up milk, ice cream, and whipped cream or buy products that don’t contain lactose. It is found in small amounts in some types of cheese, like Parmesan and Swiss cheese, which is why they are generally tolerated.

Enzyme preparations containing lactase are very useful and are recommended for administration before meals. When intolerance occurs as a consequence of another underlying disease, for example, Crohn’s disease, doctors characterize it as a secondary form. In such cases, the main condition must be treated first. Chances are lactose intolerance will disappear by itself.


How does it arise?

There is a category of special proteins within the small intestine, that is designed to carry sugar from sweet fruit (fructose) into the cells of the intestine. In the case of fructose malabsorption, either these proteins no longer properly fulfill their mission, or they are overstrained. Fructose reaches the large intestine, where bacteria process it, so that it results in carbon dioxide, hydrogen, and short-chain fatty acids.

Which are the disorders?

Those affected feel pain in the abdomen and bowel sounds, suffering from diarrhea and bloating. Fructose malabsorption can influence the psyche as well: some patients complain of fatigue after meals, or they experience a certain emotional instability. Chronic sinusitis and migraine attacks may also signal a fructose intolerance.

How to determine?

The current method is the hydrogen breath test. The person subjected to the test drinks a certain amount of fructose dissolved in water. Next, the physician measures the hydrogen content in the expired air at regular intervals, and if it exceeds the normal amount, then he can diagnose the patient with fructose malabsorption. Specialists advise against tests found on the internet as they can not offer an accurate diagnosis.

What helps?

Those who are intolerant to fructose should, at least at the beginning of therapy, avoid foods that contain this substance. They include all kinds of fruit, jam, fruit juices, and honey. Fructose is found in all types of muesli, as well as in foods whose label reads: “natural sweetener”, “fruit sweetener,” “invert sugar,” “syrup fructooligosaccharides” or “FOS.” After about six weeks, small deviations from the diet are allowed.


How does it arise?

Many varieties of cereals, for example, wheat and rye, contain a sticky protein called gluten. This protein, harmless in itself, triggers an immune reaction in people who suffer from gluten intolerance: the bowel’s mucosa irritates and intestinal villi atrophy, leading to a lack of digestive enzymes. For this reason, sufferers don’t tolerate lactose either.

In the past, celiac disease was considered one of the typical childhood diseases – but it is now diagnosed by doctors in adults as well, even those over 60, as it affects about 1% of the population. This means that celiac disease is still less frequent than fructose malabsorption or lactose intolerance.

Which are the disorders?

Children who suffer from celiac disease grow slower and have a hard time gaining weight. Adults experience bloating, abdominal cramps, diarrhea, or constipation. They often feel tired after meals, have difficulties concentrating, or are irritable. In many cases, there is a lack of vitamins A, D, and E, or some important trace elements, like iron and zinc. To avoid pathological development of malignant types, such as colon cancer, these patients need continuous treatment, for life.

How to determine?

The diagnosis of gluten intolerance is determined by correlating clinical manifestations with laboratory tests (anti-transglutaminase antibodies, anti-endomysium, anti-gliadin, anti-deamidated gliadin peptides) and histopathology tests.

What helps?

Patients with celiac disease need to have a lifelong gluten-free diet – this is the only effective therapy. Wheat, rye, spelt, oats, and barley are taboo, so are the ancient grain varieties, such as Khorasan wheat (known as the Kamut) or single-grain wheat, also any other foods derived from these. Fortunately, however, there are risk-free alternatives: rice, potatoes, corn, quinoa, buckwheat, and millet.

For many patients, intestinal villi regenerate after giving up gluten, and the symptoms disappear. If they persist, it may be the case of extreme and very rare sensitivity to this certain protein. Such patients react to the smallest amounts of gluten, for example, when special gluten-free bread is stored next to a normal one, thus contamination occurs.


How does it arise?

Histamine is a chemical mediator synthesized by the body, that plays an important role in allergic diseases, like hay fever, for example. Bacteria can produce histamine outside our body as well. The substance is found mainly in foods that have lost their freshness, the ones that have fermented or have undergone a long process of maturation, but also in those prepared by fermentation, like cheese or beer.

Ingested with food, histamine is transported together with chyme (a mixture of partially digested food in the stomach), reaching the small intestine, where it is metabolized by an enzyme called diamine oxidase (DAO). In the event of histamine intolerance, it is assumed that the functionality of the enzyme would be disrupted, but experts don’t have irrefutable evidence to support this hypothesis yet.

Which are the disorders?

Symptoms resemble those of allergies: patients have difficulty breathing and experience headaches, runny or stuffy nose, increased heart rate, and reddens of the face. Also, gastrointestinal problems often occur, mainly diarrhea. Some have itchy skin, similar to hives.

How to determine?

Histamine intolerance is not an allergy, which is why allergy tests are irrelevant. The doctor will diagnose the patient with the symptoms.

What helps?

People affected should buy their meat, fish, and seafood always fresh and prepare them as soon as possible, because of their histamine content increases during long-term storage, as well as through the process of fermentation and maturation. Therefore, salami, Parmesan cheese, Swiss cheese, canned fish, pickled cabbage, vinegar, and soy sauce contain relatively large amounts of histamine.

Also, alcoholic drinks, especially red wine and champagne, create problems. There are foods that don’t contain histamine, instead, they have the ability to release it from the body’s cells. The so-called liberators of histamine include tomatoes, strawberries, pineapple, cocoa, and crustaceans. They should also be avoided. Many patients find antihistamine medications helpful. They are divided into two categories: H1 receptor blockers and H2 receptor blockers. The first improve nasal symptoms, breathing difficulties, dizziness, and headaches, while the latter can alleviate gastrointestinal disorders.


How do they arise?

In the case of a food allergy, the immune system reacts to certain allergens that are present in the food. This happens frequently with peanuts, fruits, and chicken eggs: tingling in the mouth, mucous membranes swelling, and breathing becomes difficult. Before the onset of an allergy, the body comes into contact with very small amounts of the allergen in question and forms antibodies (IgE). They cling to the surface of lymphocytes, sensitizing them.

When a new contact occurs, the allergens activate the IgE antibodies, the cells release the histamine present in their interior and thus, the allergic reaction starts. This mechanism makes the difference between food allergies and intolerances. Another difference is that in the case of allergies, often insignificant amounts of an allergen is enough to cause violent symptoms. When dealing with intolerances, the body’s reaction depends on the quantity: thus, the occurrence of symptoms is determined by the excess consumption of a particular food.

What are cross-reactivity allergies?

Many inhaled allergens are similar to those present in food. Who reacts allergic to birch pollen often develops intolerance to apples, peaches, and berry fruits – because there are close botanic ties between them. Typical allergens with potential cross-reactivity with mugwort pollen are: carrots, celery, garlic, and pepper. Some people who are allergic to grass pollen also react to peanuts, soy products, and flour made from various grains. Patients with the “egg/poultry” syndrome initially develop an allergy to inhaled components of feathers – and then to poultry and egg yolk.

Which are the known triggering factors?

A large number of possible allergens is almost impossible to include in statistics. There are around 1,000 different substances, of which 14 are considered the most frequent triggers. They include: shellfish, eggs, fish, peanuts, soy, milk and dairy products, nuts (ex. walnuts, hazelnuts, almonds, pistachios), celery, mustard, sesame seed, mollusks (clams, among others), lupine (a forage and ornamental plant) and sulfites, sulfur-based chemical compounds, used in the production of wines. People with pollen allergies can also react to spices and various types of fruit.

How to recognize a food allergy?

During or at the end of a meal there are symptoms like: mouth burning or itching sensations, tingling mouth, and inflamed mucous membrane. Typical allergy symptoms of the digestive tract: vomiting, diarrhea, or abdominal cramps. Asthma and neurodermitis can also be included among the manifestations of a food allergy.

Those who experience the reactions mentioned above should avoid the food that caused them and make an appointment with an allergist. Food allergens can trigger serious reactions, including difficulty breathing and a collapse of the circulatory system. The most dramatic situation is the anaphylactic shock, as it requires emergency intervention because, otherwise, it ends with the death of the patient.

The best therapy: avoid, avoid, avoid – however, it’s not always possible

How to treat food allergies? The best therapy is certainly one that completely eliminates allergic reactions: thus, it’s necessary for patients to consistently avoid contact with allergens. Unfortunately, this is almost impossible in everyday life. Caution is advised when eating semi-prepared foods or products subject to laborious processing: there is usually a number of substances capable of triggering allergic reactions – soy, nuts, or combinations of spices.

Some allergens contained in food cannot withstand high temperatures, which means that they will be destroyed by boiling. It primarily involves allergens from almost all native or imported fruits.

The longer the boiling time, the better tolerated they are. Therefore, compote, jam, or jelly usually cause no problems – provided the seeds and bark have been removed carefully. Instead, thermal processing does not affect in any way allergens from nuts, celery, herbs, and spices – consistent avoidance remains the only remedy.

If, despite one’s prudence, symptoms still occur, it is likely that there was unintended contact with the allergen. Antihistamines block the action of the guilty substance in the body, alleviating unpleasant manifestations, but they do not fight the cause of allergies.

Usually, after cessation of treatment, symptoms return. High-risk patients who have previously suffered an allergic shock should always wear a first-aid set, which includes drugs – an antihistamine and a glucocorticoid – as well as a self-injectable dose of epinephrine (adrenalin).

Currently, there is only one form of therapy that targets the cause of allergies: the so-called desensitization. It aims to adjust out of control reactions of the immune system, by getting the body to gradually accustom to the allergen. Thus, the doctor inserts it into the patient’s body by intradermal injections or a few drops placed under the tongue. The dosage is gradually increased until it reaches the maximum individual limit of the patient.

In many cases, symptoms improve or even disappear altogether. Disadvantages: the therapy takes years, requires patience, and is time-consuming – and unfortunately for some patients, it’s not effective.


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1 thought on “Food Intolerance Symptoms in Adults (Lactose, Gluten, Histamine)”

  1. many people are developing food allergies later in life. My theory is that the food we are eating is much more contaminated and we are actually reacting to the GMO’S and pesticides in the food and water. Best way to stay healthy is Organic these days its getting hard to find clean chemical free food. Know that if doesnt say GMO free its GMO.


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