There are a number of potential conditions responsible for causing food intolerance, such as Irritable Bowel Syndrome, SIBO (Small Intestinal Bacterial Overgrowth), Coeliac disease, Gluten sensitivity and the list continues. However, SIBO is one of the most common reasons responsible for food intolerances, Followed by sugar malabsorption, i.e lactose, fructose, and sucrose intolerances. Before diving into the diagnosis and the ways to tackle the condition, we will first look at what the food intolerance actually means, and how the common terms such as food intolerance and food allergy are generally misunderstood.
WHAT ACTUALLY IS FOOD INTOLERANCE?
If you are suffering from food intolerance, this means that the enzymes in your gut responsible for breaking down the food particles are either deficient or there is a defect in their functioning, or the mechanism by which the nutrients are transported across the gut into the bloodstream is malfunctioned, causing maldigestion and malabsorption.
If the gut enzymes are unable to break down, for example, lactose into glucose and galactose, symptoms will show up. After undigested or malabsorbed sugars get into the large part of your intestine, it gets metabolised by the bacteria in the colon, creating gases in the process of fermentation. This is how a patient starts experiencing cramps, bloating and abdominal pain. Furthermore, the sugars in the colon (large intestine) create an osmolar gradient, which draws water into the large intestine, causing diarrhoea.
FOOD INTOLERANCE OR A FOOD ALLERGY?
Food intolerances and food allergies are sometimes misunderstood and often the terminologies interchangeably used. However, there is a significant difference amongst the two.
Food allergies are the reaction from your immune system to a protein substance in the food, which is presumed to be a foreign harmful substance by the immune system, ending up with the production of antibodies to fight off the foreign substance. All this ends up with the patient experiencing symptoms, which range from mild rash to even anaphylactic reactions (lifethreatening difficulty breathing).
Nevertheless, food intolerance has nothing to do with your immune system. It completely involves the digestive element, with the enzymes not being able to digest or breakdown the food particles properly, resulting in your food being malabsorbed, and eventually maldigestion. As discussed initially, the symptoms are typically abdominal cramps, bloating, and troublesome abdominal pain as well as occasional diarrhoea.
So, now people who suffer from digestion issues tend to ask for an appropriate test to have a provisional diagnosis. For us to understand the testing mechanisms, it is important that we consider some different kinds of food intolerances and their physiologies so that we should know what kind of testing is appropriate to find out the possible food intolerance.
SIBO & ITS RELATION TO FOOD INTOLERANCE:
SIBO stands for Small Intestinal Bacterial Overgrowth. It refers to the condition where there is an abnormal increase in the bacterial population of the small intestine. Briefly explaining, if the movement of food particles in the digestive tract slows down, it provides optimal conditions for bacteria to overgrow. This can result in food intolerance symptoms as a result of the fermentation process.
TESTING AND MANAGEMENT:
There are several tests commercially being offered to find out the cause of food intolerance. The Immunoglobulin G (IgG) antibodies are measured by skin prick testing kits. The presence of IgG does not necessarily mean that it is a cause of intolerance. In fact, this antibody has been found to be present in perfectly healthy people because the production of IgG is a normal reaction to the food particles, as clearly explained in Allergy and Clinical Immunology journal, in 2018. This emphasizes that there is already a false trend in place about home-based skin prick testing to look for the food specific IgG, which should not be practiced since there is no evidence that the food specific IgG are of any use to diagnosing any type of food intolerance, and quite worryingly, the results based on this test may lead you to avoiding some foods that your body really needs, or even you may end up eating some unhealthy foods. Therefore, if you have been experiencing the signs and symptoms suggestive of any possible food intolerance, SIBO and sugar malabsorption tests should be considered.
It is always recommended to consult with your GP or medical practitioner if you are experiencing symptoms.
