Food Allergies and Intolerances

Dr Christiane Ellul from Remedies Sliema speaks to us about food allergies and other common intolerances, symptoms and ways to address these conditions.


      Many people complain of various symptoms like bloating, abdominal discomfort or cramps, diarrhoea, lethargy amongst others, and attribute their symptoms to food allergies or intolerances. In the following article I will be giving an overview of the differences between true food allergies and intolerances, and how to recognize the different signs and symptoms.

True food allergies are most commonly seen in children, but are less common in adults, as tolerance to the offending food is developed. 85% of all food allergies in children are to peanuts, tree nuts, soy, milk, eggs, fish, shellfish and wheat. Allergy to a particular food triggers an immune system reaction that gives rise to a wide range of symptoms that usually start within minutes of exposure, and affect many different organs of the body. These symptoms can vary from mild to life threatening and may include one of more of the following: local swelling of tongue, lips and/or eyes, sneezing, itching, rashes or hives, diarrhoea, abdominal cramps, light headedness, blood pressure drop, heart rhythm problems, wheezing, shortness of breath and airway obstruction in severe cases.

As already noted, many of these food allergies disappear as a child reaches adulthood because of the development of tolerance, but allergy to peanuts, tree nuts and shellfish is usually lifelong.

Accurate diagnosis can be tricky, but is generally made through a thorough history from the patient. Appropriate specialized skin prick testing or blood measurement of the immunity levels may support diagnosis. Management of food allergies relies on complete avoidance of the offending food, and severe cases need to have an adrenaline pen at hand for accidental exposures.

Food intolerances on the other hand, are significantly more common than true food allergies. They are also common in adults.  Usually people with food intolerances can actually tolerate small amounts of the offending food. The symptoms that follow consumption of such foods however are never life-threatening and may manifest several hours after ingestion and last for days in some cases. Such symptoms are almost always limited to the digestive tract. Common complaints include bloating, abdominal cramps or discomfort, diarrhoea, flatulence and lethargy. Often symptoms overlap with symptoms of Irritable Bowel Syndrome and Fibromyalgia. One of the commonest forms of food intolerances reported is that of Lactose Intolerance.

There are no recognized diagnostic tests for food intolerances, but it is usually the exclusion of the suspected food from the diet that is a pointer towards the diagnosis. It is good to note that food intolerances rarely pose significant medical problems.

Of special note is gluten sensitivity, a much discussed topic in health forums and clinics alike. Symptoms of Coeliac Disease may be varied, and apart from the expected digestive symptoms outlined before, there can also be anaemia, weight loss and severe malaise amongst other systemic symptoms. Indeed sometimes presentation of the disease is solely through anaemia or weight loss for example, without any distinct digestive problems. One has to point out that the diagnosis of Coeliac disease relies on scientific blood tests and a gastroscopy. It is imperative that if someone is suspecting gluten intolerance to seek appropriate medical advice as failure to confirm a diagnosis and consequently lack of adherence to a gluten free diet may lead in the long term to serious health problems.

Wheat intolerance is also commonly reported in the community, however diagnosis is controversial as there are no specific tests to confirm, and coeliac testing is negative. Like other food intolerances it poses no threat to long term health and sufferers tend to be able to tolerate wheat in small quantities or specific forms.

As a concluding remark, I encourage readers to seek advice from their family doctor if they are suspecting a food allergy or intolerance, so as to have an appropriate management and referral where necessary.

Post your thoughts