Food Intolerance vs Food Allergy

Food intolerance is not the same as food allergy

Why is it important to differentiate between food intolerance and food allergy? Food intolerance and food allergy are two different medical conditions. They each require a different diagnosis and different clinical management to control symptoms.

The words "malabsorption" and "intolerance" are used interchangeably to describe the same thing -  incomplete absorption in the small intestine. Here we are referring to malabsorption of, or intolerance to, common dietary sugars such as lactose, fructose and sorbitol, and their role in causing (or contributing to) irritable bowels.

Food reactions in general are common, but food intolerance is far more common than food allergy. For example, it is estimated that up to 75% of the world's population may be affected by lactose intolerance, whereas only about 2.5% of the population are diagnosed with a food allergy. It is easy to confuse the two as a food intolerance may cause some of the same signs and symptoms as a food allergy.

Food Allergy

A classical food allergy, such as peanut or shellfish allergy, is usually characterised by an immediate and often severe reaction to a specific food, even if the food is eaten in small amounts. Food allergy involves the body's immune system, which generates IgE antibodies and histamine, resulting in symptoms such as rashes, swelling, and in severe cases anaphylactic shock which can be potentially life threatening.

Food Intolerance

Food intolerance, such as lactose intolerance or fructose malabsorption, usually produces symptoms which are more delayed and gradual. These symptoms may include bloating, abdominal cramps, flatulence, altered bowel movements and lethargy.

Food intolerance does not involve the body's immune system and you can be intolerant to several different food groups at the same time. As malabsorption is dose dependent, some people may be able to eat small amounts of the offending food without generating symptoms. These people may not be aware that they have a food intolerance. In addition, there are steps you can take to manage your symptoms. For example, if you have lactose intolerance, you may be able to drink lactose-free milk or take lactase enzyme supplements that aid digestion. Although food intolerance is not life threatening, it can have a significant impact on your general health and quality of life.

If you have a reaction after eating particular foods, it may be either a food intolerance and/or food allergy. A hydrogen/methane breath test can be used to confirm malabsorption to a particular food, but it cannot be used to diagnose a food allergy.

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