What Can I Do?
Symptoms caused by food intolerance can be wide ranging and it is important to monitor your diet closely for several weeks and keeping a symptoms diary can often be a clue as what is causing the problem.
It is also quite common for sufferers to have more than one symptom, for example they may suffer from migraines that they can identify as being caused by eating cheese but do not link the IBS symptoms or the lethargy to the same food because the symptoms are always delayed.
As more than one food is usually involved it is difficult to know whether the bread that you ate yesterday is causing your bloating or whether it is something from the day before. This is known as masking, because symptoms are delayed it is difficult to pin point the cause, this is where keeping a symptoms diary can help. By keeping an accurate account of everything that is eaten or drunk over a period of 2-3 weeks it is sometimes possible to see a pattern evolving. You may see from the diary that it is obvious that every time you eat eggs for example that 8-12 hours later you develop diarrhoea or if you have a glass of wine in the evening you suffer a migraine the next morning.
However it isn’t always that clear and there is a real danger in that omitting too many foods from your diet can cause you to become malnourished. It is also a possibility that the more foods that you cut out, the more likely you are to become intolerant to those that are left in your diet because you become more reliant on them and they are eaten far too often.
Key Points
- Keeping a food Symptoms Diary for several weeks may help identify problem foods.
- Symptoms of Food Intolerance are often delayed and may take up to 48hours to develop.
- Often the foods that you are intolerant to are the very ones that you crave and are eating more frequently.
- Rotation of foods allows you to reintroduce the foods that you were avoiding after a period of time and ensures that your nutrition is not affected.
Elimination and Challenge Diet
The most accurate way to identify whether a food is contributing to a chronic illness is by an Elimination and Challenge Diet. This should however only be carried out after a thorough consultation with a qualified dietician or nutritionist and with their supervision. Elimination diets should be followed strictly and for the correct period of time to be effective, avoiding the foods scrupulously for 5-10 days and then re-introducing the foods one at a time will usually produce the symptoms very quickly often within an hour or two enabling you to realise the food that is the culprit.
It is quite common when first removing foods from your diet for you to experience withdrawal symptoms, this is because the foods are being suddenly removed. This can explain why a person that suffers with migraine may find that missing breakfast is unwise as a migraine invariably follows. Many people experience this and symptoms will usually pass within a week however everyone is different, if it does take slightly longer, don’t give up. Some people have no withdrawal symptoms at all and start to feel the benefit almost immediately.
Often there are hidden ingredients in foods that you are not immediately aware of, it’s no good cutting out milk on your cereals and in your tea, but still having a biscuit that contains whey which is a milk derivative. You have to become an ingredient detective!
Once you have stated to feel better for a clear run of 4-5 days you can then start to try re-introducing foods. It is worth making a note of how you feel and if any symptoms reoccur as this will give you a clearer picture on what foods to avoid. Only test one food at a time starting with the major food groups such as wheat, milk or egg, do not try another food for 4 days as this will make sure that you are aware of any delayed symptoms, which can happen particularly in gut related problems.
If you do not have a reaction within that period of time it is safe to continue eating that food. This enables you to widen your diet. If you find that you do react then stop eating the food immediately, and then wait another 4 days before trying the next food. This can be a long process but is probably the gold standard in identifying the foods that may be causing your symptoms.
Once you have identified the offending foods, whether by Food Elimination and Challenge or by a blood test you will need to avoid those foods for a period of time, prolonged elimination will give your body the rest that it needs to build tolerance so that hopefully foods can be re-introduced without causing a reaction. Many people find that there is a threshold at which their tolerance can be maintained and this will vary from person to person.
Rotation Diets
After cutting a food out of your diet for a period of time, (usually about 3 months, but again needs to be carried out under supervision) the food can usually then be eaten on rotation without causing any problem. Eating on rotation means that you only consume the food or food group, (tomatoes and potatoes for example belong to the same food group), that you were previously avoiding once every 4 days. This can be quite difficult but it enables you to widen your diet nutritionally without risking a reaction. After a while you will find that it becomes ‘normal’ to eat this way and the health benefits far outweigh the inconvenience.
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