Changing Food from Adversary to Ally – Part 1

You can’t go far without before you find someone with a food intolerance. At least here in CO, I hear comments about food intolerances almost daily. It’s pretty clear that food allergies are one of the hot topics in health, wellness and nutrition. There are countless headlines about the next food that may be wreaking havoc on your body and health. So what’s the deal?

First, some definitions. 

Food Allergy: this is a life threatening response to a food. If you eat or even touch the food, you could develop a rash, shortness of breath or anaphalyxis. 

Food Intolerance: GI distress or discomfort related to consuming a food. This is NOT life threatening but very life impacting.

The AAAAI has a brief overview of the differences here and resources for food allergies: 

Many claims for food intolerance are not backed up by strong scientific evidence, so as medical professionals, we can cringe at the mention of the term “food intolerance.” They are subjective and do not have clear-cut guidelines for management. They have also become pretty popular or trendy, which can make any medical profession be a little apprehensive when they hear the term. As physicians, we are held to a high standard of treating people with evidence-based methods and not falling into the traps of trends. However, this doesn’t make it OK for providers to write-off symptoms, especially when there are effective interventions, as is the case for food intolerances.

If a patient presents with a clear diagnosis of gastritis it’s pretty straightforward what diet and medications can be used to treat the condition. But when someone has vague symptoms without evidence of disease, such as gas, bloating and G.I. distress, we’re often stuck wondering what in the world we could be doing. Lucky for us (and patients) there’s a whole field of specialists who have done additional training on this very topic. This is where functional medicine comes in. So what is functional medicine? The formal definition – Functional Medicine is a systems biology–based approach that focuses on identifying and addressing the root cause of disease.

One classic functional medicine diagnosis is irritable bowel syndrome, or IBS. Many people with food intolerances fit into this category as well. Often people who present to their primary care doctor or G.I. specialist with complaints of constipation, diarrhea, bloating, or gas end up being diagnosed with IBS. We don’t exactly know what causes it but it’s pretty clear that it’s multifactorial and can be very difficult to treat. This means that your diet, stress level and emotional health, and genes all play into why you’re feeling the way you’re feeling. This is often diagnosed after all serious medical conditions have been ruled out.

This diagnosis can be frustrating for patients. They want an answer with clear-cut treatment. Nobody wants to be diagnosed with Crohn’s disease but if they are, at least there is a treatment that they can trust and won’t necessarily require dramatic diet and lifestyle changes. Unfortunately, functional diseases often require significant diet and lifestyle changes. The good news is that they usually don’t require medicine and their treatment often results in a huge improvement in patient’s quality of life – largely because those diet/lifestyle changes have positive impacts on their overall wellness in addition to treating the symptoms.

Functional GI issues affect a significant amount of the population and can start at a very young age. IBS alone affects at least 7% of the population, likely more as many patients don’t receive a formal diagnosis. Anyone caring for children has seen the 7 year old with abdominal pain who keeps missing school or going to the nurses office. These patients almost always have at least 1 of 3 things (usually multiple):

  1. stress at home or school. This can be a new baby, recent move, parent stress (job, finances, mental health, etc…), sick family member or recent life change (starting a new grade, bullying, interpersonal troubles)
  2. not drinking enough water
  3. poor diet without enough fiber

When these issues are addressed, the child’s symptoms resolve. Children don’t have the insight to put these things together yet. They just know their bellies hurt. But when you ask about specific life events, they will be able to tell you about what is going on. They just haven’t put together that these things are linked.

This is not much different than what adults have when they present to their primary care doctors office with complaints of fatigue, bloating, constipation, diarrhea or just general abdominal upset. Parents are often motivated to help their child make necessary changes. It is much harder to get adults focus on themselves. Functional GI disorders are usually your body telling you that you’re not in alignment with the way you’re supposed to be feeling or living. This is not what most people want to hear. The good news is that these aren’t life-threatening conditions that can be totally cured with following the appropriate diet and lifestyle recommendations. Yeah!

So what does that mean? Stay tuned later this week for part 2 of this series where I break down the nutritional, physical and social/emotional approaches to treating food intolerances and IBS.

In the meantime, leave me comments on your experiences with functional GI disorders. Have you heard of them? What do you think? How have you improved your overall health through modifying your diet and lifestyle I want to hear from you!

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