Be good to your gut: managing food intolerance

As the saying goes, you are what you eat. But is what you eat making you feel sick? Dr. Jason Hou, associate professor of medicine – gastroenterology at Baylor and gastroenterologist at the Michael E. DeBakey Veterans Affairs Medical Center, answers questions about the signs of food intolerance and how to manage it.

A collection of food, such as burgers and fries, pizza, chicken sings, roasted corn and rice. The food is placed on a table and shot from above.Q: What is food intolerance? Is it different from a food allergy?

A: Food allergy and food intolerance are both very common problems. We define a food allergy as a measurable immune response to food exposure. Food allergies are common in children but uncommon in adults. Food intolerance is a much more general term that we define as an adverse physiological response, but not an immunogenic response, to food. It’s very common in adults. If you consistently feel bad after eating a specific food, we consider it a food intolerance.

Q: What are the symptoms of food intolerance? How can you tell that you have a food intolerance? 

A: Food intolerance can come in many different forms. The most common symptoms are abdominal pain, indigestion, diarrhea, gas and bloating. You may experience nausea or vomiting, but that’s not as common.

Q: How is food intolerance treated?

A: The primary management for food intolerance is to avoid that food. If it makes you feel bad, don’t eat it. In some patients, it’s not clear what foods they’re intolerant to. We may ask you to keep a food diary to identify the food intolerance, and we may refer you to a dietitian.

Q: Can food intolerance be treated with medication—for example using lactase for lactose intolerance?

A: Some patients with lactose intolerance can take an enzyme replacement, lactase, and be able to tolerate eating small amounts of lactose just fine. It’s trial and error to see how your body responds to it. I tell my patients, if you have a craving for ice cream, it’s ok to eat it. Just be aware of what may happen if you eat it. But occasional exposure won’t cause long-term harm. This contrasts with a food allergy where total avoidance is very important.

Q: Can eating foods that you are intolerant to be harmful?

A: Food intolerance typically isn’t directly harmful to the body. If you have GI distress after eating, you should see a doctor to rule out food allergies or other conditions like celiac disease. Celiac disease isn’t a food allergy or food intolerance, but if untreated, it can cause long-term problems like anemia and malnutrition. It can be treated by avoiding gluten and requires regular monitoring of nutritional and other health measurements.

Q: Any other important things to know about food intolerance?

A: Food intolerance can be a tricky thing, so it’s important to discuss with your doctor and a dietitian to manage your care. Most patients can find a balance and find things to eat; they just have to be more aware of what they’re eating. You may have to rely more on making meals at home instead of going out to eat.

Learn more about Baylor Medicine gastroenterology and digestive health services

By Molly Chiu

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