Why Am I Bloated? Your Food Allergy and Sensitivity Questions Answered!

If you have ever watched a friend you know is lactose intolerant, rip open a packeted pill, then eat a bowl of ice cream or double cheese pizza, you’ve probably been left wondering how food allergies actually work. After all, someone else you know can’t even be in the same room as a peanut shell without breaking out into hives. Dr. Tehseen Haider, a gastroenterologist board certified in Internal Medicine at Crystal Run Healthcare, answered some questions about food sensitivities.

Crystal Run Healthcare (CRHC): Are there different types of negative food reactions?

Dr. Haider: Negative food reactions can be classified into two categories: true food allergy and food intolerance or food sensitivity. Food allergies are caused by the immune system targeting different proteins present in food, causing an abnormal (sometimes deadly) reaction. Food sensitivities are not caused by the immune system but by difficulties digesting particular foods. Food sensitivity often leads to unpleasant symptoms such as gas, abdominal discomfort, or diarrhea.

CRHC: What are the symptoms of food allergies?

Dr. Haider: Food allergies can present as a wide range of symptoms. Mild symptoms are itching, hives, tearing, sneezing, nausea or vomiting. Severe or life-threatening symptoms include swelling of the tongue, difficulty breathing and throat swelling, which is called anaphylaxis. Common examples of food allergies are fish/seafood and peanuts/tree nuts, which affect 2% of the U.S. population. Food allergies can develop at any age, however, most appear in childhood. People should see an allergist if they think they might have a true food allergy.

CRHC: What about symptoms of food sensitivities?

Dr. Haider: Food sensitivities are abnormal digestive responses to different foods, often caused by enzymatic deficiencies or sensitivities and reactions to chemicals in foods. A U.S.-based survey among adult internet users suggested a 24.8% prevalence of self-reported food intolerance. The most common symptoms are abdominal pain, bloating, abdominal distension, flatulence, and diarrhea. Typically, a person experiencing these symptoms will identify having lactose intolerance, FODMAPs (fermentable oligo-, di-, and monosaccharides and polyols), or gluten sensitivity.

CRHC: What is lactose intolerance?

Dr. Haider: Lactose is the main form of carbohydrate sugar found in milk and dairy. The enzyme required for the breakdown of lactose, lactase, is present in the small intestine. People who have lactose intolerance either do not make enough lactase or the enzyme does not work effectively. This condition can also develop after food poisoning, gastroenteritis, or due to other gastrointestinal disorders. Lactose intolerance can be confirmed by breath or blood tests or by reviewing symptom history. Treatment includes eating less dairy or taking lactase enzyme supplements such as Lactaid, Lactrase, or Lactrol before dairy food intake.

CRHC: What are FODMAPs?

Dr. Haider: Certain foods contain specific carbohydrates called “FODMAPs” (fermentable oligo-, di-, and monosaccharides and polyols). When the body cannot fully absorb these carbohydrates, it can cause bloating and gas. FODMAPs are commonly found in wheat, barley, milk, certain vegetables (like broccoli, cauliflower, brussel sprouts, and cabbage), and fruits (such as prunes, apricots, apples, and bananas). It is important to speak with a doctor before attempting to decrease or avoid these types of food. A physician can educate patients on how to eliminate these foods from their diet over time.

CRHC: What is gluten sensitivity?

Dr. Haider: Gluten is a protein that is found in wheat, rye and barley. Experiencing a negative reaction to gluten is indicative of either celiac disease, an autoimmune condition, or gluten intolerance, a food sensitivity. Symptoms can be avoided by eliminating gluten from one’s diet. Although the symptoms seem similar, celiac disease can have serious consequences for a person’s overall health, whereas gluten sensitivity mostly causes gastrointestinal symptoms.

CRHC: If someone thinks they have any of these sensitivities or allergies to food, when should they see a doctor?

Dr. Haider: Food allergies can be life-threatening and food sensitivities can have a major impact on a person’s quality of life. If you think you have a food allergy or if you are experiencing any of these symptoms, you should see a physician. Undiagnosed food sensitivities can negatively impact your health and nutritional intake.

At Crystal Run Healthcare, gastroenterologists help patients diagnose and treat their food sensitivities. A gastroenterologist, or stomach doctor, will help diagnose and treat symptoms of digestive disorders, such as heartburn, constipation, diarrhea, vomiting, pain, or intolerance to specific foods. Crystal Run Healthcare has the most advanced technology and medical therapies available.

Tehseen Haider, MD, is a Gastroenterologist and is Board Certified in Internal Medicine. He earned his Medical Degree at Punjab Medical College in Pakistan. He completed his Residency in Internal Medicine and his Fellowship in Hepatology and Gastroenterology at Montefiore Medical Center in Bronx, NY. Dr. Haider has clinical interests in general gastroenterology in addition to colon cancer screenings, alcohol-related liver disease, therapeutic colonoscopy, and Inflammatory Bowel Disease (IBD). He is providing care to patients in West Nyack, NY.