Food Intolerance & Allergies

If you have an adverse reaction to eating certain foods, you may be unsure whether you have an actual allergy, or whether your symptoms are due to an intolerance. Because true food allergies can be life-threatening, it’s important to understand the differences between the two — and to seek professional medical advice instead of trying to diagnose yourself.

Characteristics of food allergies:

• The immune system mistakes the food as harmful and produces antibodies to attack it. This immune response can affect several organs in the body.

• Symptoms usually come on quickly, and may develop even after eating only a small amount of the offending food.

• While some people develop gastrointestinal problems, including vomiting and diarrhea, symptoms are usually not limited to the digestive tract and may include skin rash, hives, an itchy mouth or throat, and difficulty swallowing or breathing.

• Food allergies can cause a severe reaction, called anaphylaxis, which can be fatal if not treated quickly.

Characteristics of food intolerance:

• Eating the offending food triggers digestive problems instead of an immune system response.

• Symptoms tend to come on more gradually, and may not appear unless the food is eaten regularly or in large amounts.

• Symptoms are primarily gastrointestinal, and include nausea, vomiting, stomach pain, bloating, diarrhea and heartburn. Some people with food intolerance also develop symptoms such as headaches and fatigue.

• Food intolerance is not life-threatening.

Scripps gastroenterologists have extensive experience diagnosing and treating food allergies and sensitivities, including:

• Celiac disease, a digestive and autoimmune disorder in which eating gluten — a protein found in wheat, rye and barley — causes damage to the small intestine. When people with celiac disease eat gluten, it triggers an immune system response; however, celiac disease is not considered an allergy because it cannot cause anaphylaxis.

• Non-celiac gluten sensitivity, also known as gluten intolerance or gluten sensitivity.

• Lactose intolerance.

• Sensitivity to sulfites or other food additives, such as MSG.

• Common allergic food reactions including soy, wheat, cow’s milk, eggs, peanuts, tree nuts, fish and shellfish.

Our doctors also manage malabsorption, which occurs when the body cannot absorb essential nutrients such as vitamins, minerals, fats and proteins. Malabsorption is often caused by a related gastrointestinal disorder, including:

•Crohn’s disease
•Short bowel syndrome
•Small bowel bacterial overgrowth (SIBO)

If your gastroenterologist suspects you have a food intolerance or allergy, he or she will perform a thorough evaluation to rule out other digestive disorders and to narrow down the cause of your symptoms. Diagnostic procedures include:

• Hydrogen breath tests to confirm food or lactose intolerance, or small intestine bacterial overgrowth (SIBO).

• Lactose tolerance tests to assess the body’s ability to break down lactose.

• Endoscopy, a procedure that allows doctors to look inside your digestive tract with the aid of a tiny camera attached to a thin, flexible tube called an endoscope.

• Blood or skin prick tests to confirm the presence of food allergies or the antibodies associated with celiac disease.

Once your diagnosis is confirmed, your doctor will help you learn how to manage your symptoms and avoid future adverse reactions. Your treatment plan may include:

• Nutrition counseling by our registered dietitians, who can give you the tools you need to maintain a healthy diet while avoiding your specific food triggers.

• A referral to a Scripps allergy and immunology specialists for help managing symptoms that are not gastrointestinal in nature.

• Intravenous nutrition and hydration, vitamin and mineral supplementation, and other services as needed for patients with malabsorption.

• For patients who are interested in complementary and alternative therapies, we can provide a referral to specialists at Scripps Center for Integrative Medicine.

Scripps gastroenterologists offer consultations or care for people with food allergies or intolerance at the following locations:

• Scripps Memorial Hospital Encinitas
• Scripps Memorial Hospital La Jolla
• Scripps Mercy Hospital (San Diego and Chula Vista)
• Scripps Green Hospital
• Scripps Clinic Carmel Valley
• Scripps Clinic Encinitas
• Scripps Clinic Rancho Bernardo
• Scripps Clinic Rancho San Diego