Day 15- Food Sensitivities

Welcome to Day 15!

Not everyone with celiac disease or gluten sensitivity have other food sensitivities, but it's fairly common. If you find yourself not feeling better and struggling with symptoms, trying an elimination diet can be helpful in relieving your symptoms.

Today you'll learn:
How to find out if you have any other sensitivities
How to follow a basic elimination diet plan
What the difference between a sensitivity and allergy is

Celiac disease and lactose intolerance
It's common for those newly diagnosed with celiac disease to have temporary lactose intolerance. This type of lactose intolerance is called “secondary lactose intolerance.” It is a temporary form that develops as a result of celiac disease and resolves (in most cases) as the intestine heals. When you have celiac disease, the mucosa (or lining) of your small intestine is damaged. Specifically, the villi become shortened or even completely flattened. This results in a decrease in brush border enzymes. This temporary lactose intolerance takes typically 2-3 months to allow for regeneration of adequate amounts of lactase. Many adults have lactose intolerance regardless of having celiac disease so if you find yourself continuing to have symptoms you can get tested for lactose intolerance.

What's the difference between a food intolerance and sensitivity?
The difference between an intolerance and a sensitivity is a food intolerance involves not having the enzymes in the gut to digest the food properly, a sensitivity causes symptoms but not because of a lack of enzymes or an immune response like an allergy.

Food Intolerance

A food intolerance differs from an allergy in that there is no immune system response to the offending food. When a food intolerance exists, the problem is at the level of the digestive system – the GI system’s inability to digest the food causes uncomfortable gastrointestinal symptoms. Food intolerances include lactose, fructose, yeast and histamine intolerances.

Diagnosing Food Intolerance

Diagnosing a food intolerance can involve a food diary where you can see what symptoms you may be having. You can also do a breath test if you suspect lactose intolerance, this can be done at your doctors office. Doing an elimination diet can also be helpful in a diagnosis. 

What is a food sensitivity?

Food allergies are well-recognized due to the fact that firm diagnoses can be made through the use of blood tests for the presence of IgE antibodies, food sensitivities fall into a greyer area. Food sensitivities, e.g., experiencing unwanted symptoms after eating certain foods, are not as easy to diagnose, but it doesn't mean that they are any less real.

food sensitivity symptoms are milder, are not immediate, and are not life-threatening. They tend to be mainly digestive in nature (bloating, diarrhea or constipation, stomach cramps, and gas), and may not surface for up to several days after you consume the offending food.

    Diagnosing Food Sensitivities

    Food sensitivities can be difficult to diagnose, and the symptoms overlap with a variety of other conditions. Therefore, it's important to discuss your symptoms with your doctor. It's recommend that you undergo further testing or keep a food diary to help get an accurate diagnosis.

    The best way to identify a food sensitivity is through the use of an elimination diet, followed by a "challenge" phase in which you re-introduce the food and assess for symptoms. Although this process is certainly more time-consuming than a simple blood test, it is essential to make sure that you accurately identify your particular sensitivities, so as to reduce your risk of eating an overly restrictive diet.

    Throughout the process you will want to be keeping a food diary, as other factors, such as weather, mood, exercise, and menstrual cycles, can all affect your GI functioning and digestive and overall symptoms.

    Should I get tested for food sensitivities?
    You may see blood tests being offered for food sensitivities but don't waste your money. There is no scientific proof that these tests are reliable.

    Why and How Does an Elimination Diet Work?

    A very large proportion of our immune system, roughly 70 percent, is actually held within our digestive tract, specifically in the gut. Therefore, our gut and brain have a very close working relationship. Every time we put something into our mouth and it travels through our digestive tract, our gut sends signals to our brain – and vice versa.

    Within the gut, we have what is called the enteric nervous system, a series of neurotransmitters that are capable of sending chemical messages to the brain that trigger the release of digestive enzymes, hormones and inflammatory responses.

    This back-and-forth communication is how we know when we are hungry and when we are full. It’s also how our gut and brain work together to communicate signs of a food intolerance, allergy, bacterial infection or a nutrient deficiency. When you eat something that triggers a “red flag,” your immune system and brain react by creating inflammation – swelling, pain, tenderness and sometimes visible redness that are all a result of the body’s white blood cells attempting to protect us from infection of foreign organisms.

    During an elimination diet, someone cuts out all culprit foods, usually for about a month or so, and then reintroduces them one by one to see how they feel when they eat the food once again. If the inflammatory responses stop when the food is removed but then return once reintroducing the food, then it’s clear that the food should be eliminated altogether.