Suspected food allergies and intolerances require a proper diagnosis by qualified health professionals. It is important that you get investigations done by specialty doctors (e.g. immunologists, gastroenterologists, dermatologists, neurologists).
Having a diagnosis of a food allergy, food intolerance or Coeliac Disease means that other diagnoses have been ruled out, and I can provide the latest evidence-based advice to help manage your condition.
This will involve educating you about how strict you need to be with your diet, how safe your level of strictness is for your health, as well as giving you guidance over time when your circumstances change.
For those who think food could play a role, dietary investigations in the form of Elimination diets can be done with my support and guidance.
When modifying your diet to exclude certain food components, it is important to seek the advice of a specialist allergy and food intolerance Dietitian to ensure you are meeting your body’s nutritional requirements.
Taking out one food component will change your diet nutritionally as well as change other food components that you are not aware of e.g. additives. I have seen many clients get confused and waste a lot of time and effort modifying their diet inappropriately without expert guidance.
Advice and support from the Dietitian is required before, during and after any dietary modification to ensure nutritional adequacy, compliance and accurate interpretation of results.
Please be aware that there are many unorthodox tests available aimed at identifying food allergies and intolerances where results are often misinterpreted, inaccurate and unreliable.
Food Allergies
Food Allergy is an immune response to a specific protein in food. It is usually an immediate reaction to a food that mostly occurs in childhood and, in some cases, can be outgrown. Reactions can range from mild (eczema, hives or gut problems) to life-threatening anaphylaxis.
Skin prick tests or blood tests (RAST) can be done to indicate the likelihood of allergy. An allergy doctor is required to take a detailed history and interpret the results in order to diagnose an allergy.
Food Allergy is an immune response to a specific protein in food. It is usually an immediate reaction to a food that mostly occurs in childhood and, in some cases, can be outgrown. Reactions can range from mild (eczema, hives or gut problems) to life-threatening anaphylaxis.
Skin prick tests or blood tests (RAST) can be done to indicate the likelihood of allergy. An allergy doctor is required to take a detailed history and interpret the results in order to diagnose an allergy.
Lactose Intolerance
Lactose intolerance occurs when the body does not produce enough of the enzyme lactase to digest the lactose in dairy products. It presents as abdominal pain or discomfort and diarrhoea after consuming dairy products containing lactose.
In many people, lactose intolerance is genetic. However, there are other causes such as gut damage from gastroenteritis or other gut conditions such as Coeliac Disease. Therefore, it is important to ask your GP to do the right investigations if you are not sure why you have lactose intolerance.
I can help you manage your lactose intolerance and guide you on whether it is a true lactose intolerance or identify other dietary components contributing to your symptoms.
FODMAPS
FODMAPS stands for Fermentable -Oligo-Di-Mono-saccharides and Polyols. In other words, these are the ‘windy foods’. In anyone, a high enough amount of the FODMAPS foods gives an array of gut symptoms such as bloating, pain and diarrhoea. Those with IBS do not have more wind in their bowel from these windy foods but have more nerve endings in their gut (likely caused by the food chemicals), which means they sense the discomfort more. Understanding the food triggers is important in the management of IBS.
Food Chemical Intolerance
Food chemical intolerance occurs when symptoms are caused by one or more natural (salicylates, amines, glutamates) or artificial food chemicals common to many different foods. People who are intolerant usually react to more than one food component, and those very sensitive also react to cows milk, soy or wheat.
Food chemical intolerance can often seem outright weird. It can affect more than one body system and even look like an allergy. The way food components affect various symptoms is as unique as each person’s face. Some symptoms of food chemical intolerance include but are not limited to:
Skin- eczema, unexplained rashes, hives, itchiness, skin swellings (angioedema).
Gut- mouth ulcers, reflux, irritable bowel syndrome (IBS), abdominal pain, bloating, excess wind, diarrhoea, constipation.
Respiratory- non-allergic rhinitis (hayfever symptoms).
Central nervous system- sleep problems, poor concentration, mood changes, hyperactivity, headaches, migraines, anxiety, depression.
Food chemical intolerance is not well known by all health professionals, including general dietitians. It is a very complex area and requires a professional with the specialist knowledge and expertise to make an assessment, rule out other medical conditions and provide the right advice.
There are no reliable medical tests that can identify what food components or chemicals a person is intolerant to. Food chemicals have a build up effect in the body. Symptoms can be delayed for up to 3 days after eating the trigger, and they can last for up to 3 weeks in people who are very sensitive.
The RPAH Elimination diet also known as FAILSAFE with challenges is the only best test method to find out what food chemicals are the problem. After the test diet and challenges are complete, the diet variety is increased (liberalisation), and food chemical tolerance levels can be increased slowly and gradually over time.
As a Specialist Food Intolerance Dietitian, I strongly encourage my clients to keep in touch with me throughout the elimination, challenging and liberalisation phase of the RPAH Elimination Test Diet to ensure you are complying with the diet, interpreting symptom reactions correctly during the different phases, obtain information on the challenging procedure and receive guidance when liberalising and increasing your tolerance threshold.
If you would like to donate to fund food allergy and intolerance research, you can donate here by selecting Royal Prince Alfred Hospital and then select the Velencia Souter Memorial Fund.
Coeliac Disease
Coeliac Disease is an inflammatory condition of the gut. It often presents as gut symptoms such as bloating, diarrhoea or nutrient malabsorption, e.g. iron deficiency, because gluten, a protein found in wheat, rye, barley and oats, causes damage to the small bowel.
Today it is thought that 50% of people with Coeliac disease do not have gut symptoms and may have the following symptoms:
- Vitamin and mineral deficiencies
- Fatigue, weakness, poor concentration, irritability
- Faltering growth
- Weight loss
- Dermatitis herpetiformis (a type of skin rash)
- Easy bruising of the skin
- Recurrent mouth ulcers, face or tongue swelling
If Coeliac disease is in the family or suspected, tests must be done to screen, confirm, or rule it out.
Scientists are quickly learning more and more about Coeliac disease. Working with one of the leading Coeliac Dietitians in Australia at the RPAH Allergy Unit, you can be sure that I am up to speed with the latest Coeliac Disease dietary guidance around testing procedures, Australian food labelling laws, adherence to the strict gluten-free diet as well as ensure your body gets all the nutrients it needs.
More information about Coeliac Disease and its diagnosis can be found at http://www.coeliac.org.au/.