Not all food reactions are the same.
There are 4 parent pathways in our body that can lead to food reactions.
1. COELIAC DISEASE
This is an auto-immune T-cell mediated reaction, not an allergic reaction to wheat.
Coeliac disease is the only autoimmune disease where the trigger, gluten, is known.
The damage to the small intestine results in nutritional deficiencies and possible long-term medical complications.
It is thought that about 1 in 70 Australians have coeliac disease and that about 80% of this group remain undiagnosed. Coeliac disease can be diagnosed at any age, so one negative test for coeliac disease may not mean negative for life.
Gastrointestinal problems such as nausea, vomiting, diarrhoea, bloating and weight loss are commonly experienced. However, we now know that people who appear to have no symptoms at all can in fact have coeliac disease. The signs and symptoms which could be overlooked are feelings of general malaise, headaches, low blood iron, osteoporosis, infertility in females, constipation, loss of tooth enamel, short stature, apparent food intolerances to name some.
If the disease remains undiagnosed or gluten remains in the diet, cancers of the gastrointestinal tract, osteoporosis, liver and heart disease, neurological effects or refractory (unresponsive) coeliac disease may be some of the long term medical outcomes encountered.
A diagnosis of coeliac disease must be obtained from a medical doctor before gluten is removed from the diet.
Dermatitis herpetiformis is sometimes called coeliac disease of the skin. This condition also requires a life-long gluten free diet.
2. FOOD ALLERGY
Food allergic reactions involve the immune system identifying certain foods as a ‘threat’ to the body. While to most people this food is harmless, the immune system in a food allergic person causes the body to make IgE antibodies to a portion of the protein molecule of that food causing the ‘threat’.
The most common food allergies are to egg, milk & nuts, followed by seafood, wheat and soy.
The symptoms vary but can include blocked, runny or itchy nose, hives, eczema, wheezing or shortness of breath, swellings, vomiting and diarrhea. If the reaction is severe, the breathing difficulties increase, throat swelling and a drop in blood pressure can occur, which leads to a severe allergic reaction known as anaphylaxis.
Food allergies must be properly diagnosed by an Allergy Specialist. Total avoidance of the food is most often required in small children. Food challenges in the presence of the doctor are done to determine if and when small amounts of the food may be eaten.
Find an Allergy Specialist near you for diagnosis and management. Your GP can recommend specialists. Also visit these websites:
3. FOOD INTOLERANCES
The term Food Intolerance is used to describe a non-allergic hypersensitivity reaction to a food or food substance that causes varied physiological responses such as headaches, migraines, asthma, hives, rashes, fatigue, brain fog, joint pain, nausea, bloating, wind, abdominal pain, diarrhoea, irritable bowel and other symptoms.
These reactions do not involve the immune system. A skin prick test cannot diagnose a food intolerance.
Food Intolerances are much more common than food allergies. The onset of symptoms is not always immediate, and the food trigger is often not recognized. Few people need to totally avoid the food or substance involved.
4. ENZYME DEFICIENCIES
Our body produces enzymes to break down our food proteins, fats and carbohydrates to release the necessary elements required for our body to function. In some people, there are genetic reasons why these enzymes are not working correctly and so the body cannot properly digest the food and symptoms result. Sometimes this can lead to major medical conditions that require specialist help.
On a lesser spectrum of severity, lactase deficiency is quite common.
Lactase is the enzyme that breaks down the lactose sugar in milk. When the lactase enzyme is in short supply people can develop diarrhoea, wind, bloating or cramps to dairy products.