Lactose, gluten: how do you know if you have a food intolerance? – 2022/05/14

For most people, eating is a pleasant feeling, while for others, eating certain foods can make them sick and cause a lot of stomach upset, such as intolerance.

“Food intolerance is a detrimental reaction of the body, especially in the digestive tract, due to the difficulty of digesting a particular food,” explains clinical nutritionist Karina Gama of the Dante Institute. Pazzanese Cardiology. He argues that discomfort can be caused by a lack of action or defects in the enzymes that “break down” certain food ingredients, as well as by substances in foods that cause difficult digestion.

Among food intolerances, lactose intolerance is the most common, and occurs when lactose, which is responsible for digesting lactose, milk sugar, and derivatives such as cheese and yogurt, is deficient in the digestive enzyme lactase.

But there are also intolerances to gluten (or non-celiac sensitivity to gluten), fructose (sugar found in fruits, certain vegetables and cereals, and processed products), sucrose (table sugar), and intolerance to undigested carbohydrates, which are then fermented. intestinal bacteria and also known as fodmaps (derived from milk, fruit, cereals, legumes, and some sweeteners).

Anyone can have a food intolerance and the predisposing factors depend on the individual’s condition, such as genetics, health status, immune status or the food itself, such as potential allergen, conservation and ingestion, according to Hélcio Maranhão, gastroenterologist and pediatrician. nutritionist, Professor of Pediatrics at the UFRN (Federal University of Rio Grande do Norte).

In the case of those with intolerance, the symptoms may appear sooner or later after eating, and may last for hours.

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How to identify food intolerances?

Symptoms and signs may be different, but are generally related to the digestive tract: cramps or abdominal pain, bloating, distension, bloating (nausea), nausea, regurgitation, flatulence, constipation, and even diarrhea. There may also be systemic symptoms such as irritability, fatigue, migraines, hives, and joint pain, according to Auzelivia Rêgo Falcão, a gastroenterologist who teaches gastrointestinal and coloproctological diseases in the UFRN’s Department of Integrated Medicine.

Symptoms may appear after eating the food or some time later and may last for several hours. Relief usually occurs after complete fermentation of undigested ingredients by intestinal bacteria or the elimination of the substance through feces.

But it’s important to make it clear that feeling bad after eating food doesn’t lead to food intolerance. “That’s because there are some digestive diseases that can cause similar symptoms, including food poisoning,” says Falcão.

To suspect the condition, follow-up and persistence of symptoms is necessary when consuming food at different times. “It can be helpful to make a food diary that describes the symptoms and foods eaten that day,” the gastroenterologist added.

If the person suspects intolerance, it is recommended to discontinue food in case. “This measure is expected to help reduce and resolve the symptoms. After a few weeks, it may return to food to see if those symptoms return. If so, there is a high probability of becoming ill.” , says Maranhaok.

If the onset of clinical symptoms is persistent, a physician or nutritionist may perform a thorough evaluation to confirm the diagnosis. This includes medical history research, medications or supplements used, lifestyle habits, bowel function, and dietary habits.

What tests can be done?

Some laboratory and specific tests may assist in the diagnosis. These include oral tolerance testing, which helps to identify lactose intolerance, e.g. This test consists of offering the person the substance under investigation, on an empty stomach, and after 30, 60, 90 and 120 minutes, receiving blood to see if the fasting glucose has risen by at least 20 mg / dl. , as a result of the digestion of the substance under study. If the rise in blood glucose is lower, it is seen that the digestion was incomplete and there was no proper absorption.

The expired hydrogen test uses the same principle as the oral tolerance test, but instead of assessing the change in blood glucose, the patient blows a device that measures the amount of expired hydrogen in the fasting state after swallowing the standard solution studied. 2 to 4 hour intervals.

“In an intolerant patient, the undigested and unabsorbed substance is fermented by bacteria in the last part of the intestine, forming hydrogen. Therefore, increased detection of hydrogen in the breath reflects the inability to properly digest and absorb the substance.” , explains Karina Gamak, a master in food science.

Other tests that can still be used, such as the fecal acidity test commonly used in infants or children, intestinal biopsy, and genetic testing, are more significant when conventional tests are not more significant. For non-celiac gluten sensitivity, tests are performed to investigate celiac disease.

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In case of suspicion, it is advisable to seek medical attention and a doctor’s examination and tests so that the person does not have unnecessary dietary restrictions.

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Intolerance and allergies are different

Tests to confirm the diagnosis are important, even if the food intolerance does not interfere with the food allergy, as the conditions are different.

As mentioned, food intolerance is the lack of an enzyme that is responsible for the digestion of a particular food, causing it to be difficult to absorb. It is a condition that causes more local symptoms, associated with the digestive tract.

Allergies, on the other hand, are immune phenomena that can cause general reactions or endanger various devices, such as the skin and respiratory system, in addition to the digestive system.

How is the treatment?

According to the experts consulted in the report, the treatment of food intolerance should be individualized and based on reducing or eliminating the foods that cause the problem.

Some people may suffer from small amounts of the product, but this limitation is individual. In lactose intolerance, lactose-free or low-lactose products should be given priority. It is also possible to use the enzyme lactase in the form of tablets or powders to dilute in liquids, before or with a lactose-containing food. This may reduce the appearance of symptoms, but may not be completely effective.

The range of nutritionists stressed that “any intolerance must be properly diagnosed by a healthcare professional so that unnecessary restrictions on food are not made.”

Sources: auzelivia Trench Hawkgastroenterologist, professor of gastrointestinal diseases and coloproctological UFRN (Federal University of Rio Grande do Norte) Department of Integrated Medicine also works at Onofre Lopes University Hospital (HUOL/ UFRN); Helcio Maranhãogastroenterologist and pediatric nutrologist, Senior Lecturer in the Department of Pediatrics at the UFRN, Secretary of the Department of Neurology of the Brazilian Pediatric Association; Karina GamaClinical nutritionist at the Dante Institute Pazzanese Master’s degree in Cardiology and Food Science from the USP (University of São Paulo) Faculty of Pharmaceutical Sciences.

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