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Food intolerance is relatively a new concept, and can be difficult to understand. Even most doctors have a poor understanding of it, particularly when there is a mixture of signs and symptoms that do not belong in the same disease group or there is no pathological explanation.

Common complaints such as headaches, bloating and tiredness after eating may be due to food intolerance. Importantly, this is different from food allergy which occurs as an immune reaction that releases the chemical histamine into the tissues, causing itchy rashes, stomach upsets, cough, wheeze and more severe life threatening anaphylaxis symptoms. At times symptoms of  food intolerance can be similar to food allergy reactions, which can cause confusion. A food allergy will normally show up on allergy tests, however food intolerance may not. For this reason having food allergy tests do not always give the answers that we seek.  One way to look at this is as a spectrum, where food allergy is at the severe end whilst food intolerance is found in the middle with good health at the other end.

In food intolerance substances in food can increase the frequency or severity of existing symptoms or cause new symptoms. This can depend on the amount of the offending food that is eaten. Small amounts may not cause any problems, whilst larger amounts will give rise to troublesome symptoms. The reaction time to an intolerant food varies and since we eat and drink many times a day, sometimes we may get a confused picture of the problem.

Food intolerance adverse reactions may include;

  • General feeling unwell after eating e.g. bloating, heartburn and indigestion.
  • Malaise, tiredness and feeling sleepy.
  • Headaches, arthritis and eczema.
  • Flushing, nausea and bloating.
  • Diarrhoea and/or constipation.
  • Aversion for certain foods where the person not only dislikes the food, but also reacts at the sight or smell of the food. In some this is triggered by emotional association with the food.
  • Underlying anxiety can cause hyperventilation and considerable distress resulting in dizziness, tight chest, blurred vision, unusual body sensations or numbness.
  • Gut upset, weight loss and anaemia.

Food intolerance causes include;

  • Enzyme deficiency e.g. lactose intolerance.
  • Food poisoning: A history of gastroenteritis or food poisoning can leave longer term digestive problems.
  • Food additives: In sensitive people additives used for food preservation, consistency, colour and taste can trigger symptoms e.g. sulphites used to preserve dried fruits and canned goods, and some sweeteners can cause headaches.
  • Certain conditions e.g. irritable bowel syndrome increases the risk of food intolerance.
  • Celiac disease is triggered by eating gluten (found in wheat and other grains). There are some features of food allergy, but symptoms are limited to the digestive system.
  • Continual or recurring stress, or psychological factors.

Diagnosis of food intolerance is based mainly on a detailed history, response to treatment and a continual process of dietary review over a period of time. As explained earlier allergy tests are of little value. The history will help to identify the offending foods or other factors that aggravate symptoms. Often people are able to recognise some of the foods themselves, or by a process of trial and error i.e. by temporarily excluding a suspect food from the diet. Using a food diary to keep a record of what is eaten and any symptoms that may develop during that time is very helpful. Another way is to avoid all suspect foods from the diet until there are no symptoms, followed by a gradual reintroduction of one type of food at a time to see which cause symptoms. In both cases there is a risk of having an inadequate diet, therefore always seek advice from an experienced and knowledgeable medical or health practitioner.

In my experience the use of a combined integrated approach to treat food intolerance offers excellent results. It is important to remember that every treatment plan is individualised to the person, as each person is unique and different in the problems they experience. Additionally, they also vary in their response to treatments. In general following a detailed history every treatment will start with a dietary review, followed by reducing or avoiding the intake of problem foods. Learning to read ingredient lists of processed foods is key to ensuring that the appropriate foods are avoided. Often I find that there is a poor understanding of processed foods and what they may contain. In many cases because of deterioration in health there is food hypersensitivity, where people start to react to non-problem foods and present at my clinic with a very confused picture. Regular acupuncture treatments aimed at restoring healthy body function, by enhancing blood circulation, immune function and flow of Qi (energy), will help calm the body and reduce reactivity to foods. It also eases abdominal cramps, nausea, stress and anxiety. Where necessary multivitamins and supplements are advised to help reduce nutrient deficiencies, alleviate symptoms and in the long-term promote healing of the gut.

References:

  1. Food intolerance (2014). Australasian Society of Clinical Immunology and Allergy (ASCIA) http://www.allergy.org.au/patients/food-other-adverse-reactions/food-intolerance
  2. Li JTC, (2016). What’s the difference between a food intolerance and food allergy? http://www.mayoclinic.org/diseases-conditions/food-allergy/expert-answers/food-allergy/faq-20058538

 

Flavourings and preservatives have been used for centuries to enhance the taste and freshness of food. Do you wonder if they may be unsafe to eat?, or have you tried to identify all the additives that are in your food ?

Additives are not naturally found in food. They serve a number of purposes;

  • Colours  that add or restore lost colours to food.
  • Preservatives that help protect against food deterioration caused by bacteria.
  • Antioxidants that slow down or stop the oxidative deterioration of foods, e.g. when fats and oils go rancid.
  • Artificial sweeteners which impart a sweet taste for fewer calories than sugar, but also cheaper to use.
  • Flavour enhancers that improve the taste and aroma of food.
  • Presentation and texture enhancers e.g. thickeners, gelling agents, emulsifiers, emulsifiers.
  • Nutrient additions that increase the nutrient value of foods

Without many additives our food may not taste as nice, bread would go sour more quickly. Some foods will no longer be worth eating due to their low nutrient value.

Traditional methods of preservation include; smoking, salting, vinegar and drying are accepted for their long standing safe historical use. The use of additives has to go through a lengthy process to prove that they are safe to use, but despite this there are still many concerns. Below are some of the problems that additives may give rise to.

Allergy

  • Sulphite and sulphur dioxide (E220-28) have been known to cause allergic reactions. Specifically, asthma sufferers should avoid sulphur dioxide gas due to increased sensitivity, but there are also recorded cases of worsening of asthma after drinking soft drinks containing it. They are mainly found in dried fruits, dessicated coconut, relishes and fruit-based pie fillings.
  • Food colours like tartrazine (E102) can cause mild allergic reactions and some studies show that sunset yellow (E1 10) can cause tumours.
  • Annatto, a natural food colouring found in margarine, cheese, smoked fish and cakes is implicated in allergic reactions and irritable bowel.

Cancer

  • Aspartame (E951) has been linked to various cancers(1,2,3), although studies by US National Cancer Institute and European Food Safety Authority concluded that it did not increase the risk of cancers.
  • Erythrosine is a red food colour. Research has highlighted concerns about its potential tumour formation and inhibition of the normal functioning of the thyroid.
  • Allura red has been associated with cancer in mice but evidence is not consistent.
  • Nitrites and nitrates (E249-52) may convert to potentially carcinogenic nitrosamines.

Hyperactivity

  • Although a definitive link has not yet been established food colours like, sunset yellow (E110), quinoline yellow (E104), carmoisine (E122), allura red (E129), tartrazine (E102) and ponceau 4R (E124) have been associated with hyperactivity in some children. These are commonly found in a variety of processed foods, especially in children’s sweets, confectionary, squashes, soft drinks, jams and cakes. Prevalence of hyperactivity is estimated to be about 2.5%.
  • Aspartame has also been linked with changes in behaviour.

Headaches

  • MSG (monosodium glutamate- E621) is a flavour enhancer can cause headaches in some people. Although in a recent review there was no conclusive direct evidence.
  • Aspartame is also linked with causing headaches.

Other


The Bottom Line

Additives are overused in the processed foods industry, so try to avoid them as much as possible.

  • Keep processed foods to a minimum, including sweets, lollies, soft drinks and cakes.
  • Be careful of foods that are presented as low-fat, sugar-free as majority will contain some form of additive.
  • Not everyone reacts to additives in the same way. If you experience signs of reacting to certain foods, then minimise or avoid eating it.
  • If your child shows signs of hyperactivity of attention deficit hyperactivity disorder (ADHD) then eliminating some colours from their diet may prove beneficial.
  • Always read food labels to be fully aware of what you are buying.

 

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It’s not uncommon for the proponents of conventional and of holistic systems of medicine to feel that they inhabit competing camps in the war to alleviate human suffering. In fact, Western and Eastern medicine are essential branches on the great tree of scientific knowledge.  Many of us are working towards the ideal of a continuum of care that provides the very best treatment to all patients. Western medicine has achieved remarkable triumphs.  Vaccination against many infectious diseases has greatly reduced their incidence; science has eradicated smallpox and come close to doing the same for polio.  It has saved millions of children from the scourges that once prevented so many from reaching their fifth birthday.

The specialties of surgery and emergency medicine save countless lives every day.

After decades of clinical practice I still wonder; Where does Western medicine fall short?  In the promotion of lifelong wellness; in the diagnosis and treatment of complex disorders; in the unnecessary or excessive use of pharmaceutical drugs; in safe, effective, ongoing pain management.

We’re certainly making progress in bringing these two branches of medicine closer, for example;  acupuncture has been proven to offer effective pain relief and increasingly accepted in medical pain clinics, and it doesn’t carry the risks associated with drug-based analgesia. Integration of auricular acupuncture in addiction clinics is another measure of its success. There is worldwide recognition of acupuncture for anxiety and stress particularly in cancer treatment, post traumatic stress disorder amongst veterans, and its potential value as anesthesia during surgical procedures.

I have always found that it is necessary to treat the whole person, and not just deal with an immediate crisis or what presents as their most significant symptom. I wanted to share this story (to ensure anonymity names and certain details have been changed).

Ria’s Story-  “Please… I Just Want the Pain to Stop”.

In the hospital waiting room Ria’s stomach churns and twists once again sending shooting pains throughout her body, followed by a cold sweat.  Over the past six months, she’s seen six different doctors; has endured repeated blood tests and other procedures.  No one has been able to offer her a definitive diagnosis. After each visit, she’s sent home with different prescriptions but no effective treatment for the repeated, alternating bouts of diarrhoea and constipation, sometimes nausea too.  Pain medication doesn’t bring any relief.  Her husband Pete feels equally anxious and frustrated.

Visits to six different doctors, blood tests and investigations all have proven to be unhelpful – there is no definitive diagnosis. Each time she is sent home with new meds, pain medication doesn’t work, one tells her that she is stressed and emotionally disturbed and prescribes her antidepressants another says there is some inflammation in her spleen, but nothing else. Ria is desperate, her symptoms are worsening.

Ria is beginning to doubt herself; wondering if it really is “all in her mind.”  She’s afraid to eat because everything just makes her feel worse, and she’s now two sizes smaller.

After yet another round of tests, Ria’s new consultant is also perplexed by her symptoms.  His examination of her shows nothing significant.  He’s ruled out cancer or other serious disease; all her other results are relatively normal. But fortunately for her, this doctor takes the time to listed to her and has a positive view of complementary therapies; he understands that functional disorders often underlie a patient’s stress and anxiety.  He knows that food intolerance is increasingly common and is often very hard to properly pinpoint. He asks her if she would be willing to accept a referral to a holistic physician.  Ria has always had an interest in complementary therapies and gladly agrees. He also gives her advice on juicing and enrolls her on to a mindfulness course.

As a holistic practitioner, I see Ria’s physical and emotional distress to be strongly interrelated, but requiring individual attention, with this in mind I begin acupuncture treatments. Almost immediately, they help to ease her distressed state and bring some relief for her stomach pain.

Over a period of months I guide Ria to make changes to her diet.  Together we develop a plan to identify problem foods. She learns about carbohydrate intolerance and how the FODMAP diet can help.  Ria finds the mindfulness course very effective in relieving her anxiety.  She began to realize her physical and emotional distress began years before the manifestation of painful bowel dysfunction.

Six months after starting treatment, Ria has made great progress.  She knows it will take time to regain the good health she thought was out of her reach, but she is no longer frightened and discouraged.  She is starting to take pleasure in eating again.  She and her husband are now enjoying what they thought might never be possible again–everyday pleasures.

 

Irritable bowel syndrome (IBS) is a common chronic conditions of the digestiveStomach pain system found in around 1 in 5 people. Women are 2-3 times more likely to develop IBS. It is characterised by bouts of abdominal cramps, bloating, flatulence, diarrhoea and/or constipation. The severity varies from one person to another. They can last from a few days to months. Symptoms may ease after going to the toilet, often the condition is life-long. Unfortunately the cause of IBS is unknown, but most people find it is related to an increased sensitivity of the gut and problems with digesting certain foods. Stress is also a known contributor. IBS can be painful and debilitating affecting personal, social and professional life. Treatments for IBS are mainly limited to symptom control, stress reduction, altering the amount of fibre in the diet, regular exercise and identifying trigger foods in the diet.

IBS is described as a functional problem, which means that anatomically or physiological investigations are completely normal. Instead there is impairment of the body’s normal function. This makes it difficult to treat. An increasing number of studies have found that IBS can be safely and effectively managed using acupuncture.

In Chinese medicine, IBS is considered to be an imbalance between the liver and spleen. The liver is associated with emotions and stress, while the spleen is linked to digestive function in the body. A weak spleen Qi (energy) allows the liver to dominate. When this occurs over a long period of time the continued disharmony causes IBS symptoms to manifest.

Acupuncture
Research evidence has consistently demonstrated that a course of acupuncture improves IBS symptoms and general wellbeing. These include;
• Pain relief
• Regulating the motility and movement of the digestive tract
• Reducing gut sensitivity
• Reduce stress related sympathetic nerve impulses e.g. abdominal spasm, by increasing the parasympathetic tone of ‘rest and digest’.
• Reducing anxiety and depression by increasing production of mood altering chemicals serotonin and endorphins.

Nutrition
IBS related changes in diet are individualised. It should focus on identifying trigger foods and eliminating them from the diet. These can vary from wheat, dairy, alcohol, coffee, fatty foods and some fruits and vegetables In the case of constipation adding adequate fibre to the diet is helpful. Some people may find that soluble fibre like, oatmeal, berries, legumes, beans and lentils are easier than insoluble fibre from raw vegetables and bran. Probiotics, multivitamins and minerals can be helpful to normalise the digestive environment.

Life style changes
Some of the following lifestyle changes can benefit IBS symptoms, but are also good for general health and well-being.
• Regular exercise to relive stress, regulate the bowel and alleviate constipation
• Practicing meditation, mindfulness, yoga, breathing exercises will help to manage stress levels
• Good and adequate sleep is important for everyone, but particularly for those with IBS. It helps the body to rest and heal. Tiredness increases stress and irritability which in turn triggers IBS.

Book an appointment or Call  07810024687 to discuss your needs with Dr Rhonda Lee. Dr Lee is a Holistic Physician trained in medicine, acupuncture, nutrition, aromatherapy, massage and other techniques. She specialises in digestive disorder, chronic fatigue, pain management and stress and depression.

Having to change to a gluten-free diet can be very challenging for  those who eat Chapatti (flat-bread) as a central part of their diet. For anyone with an allergy or intolerance to gluten, the chapatti / paratha / puri is by far the most missed item, particularly in an Indian meal. On its own gluten free flour does not offer the right consistency or form to be able to make good chapattis, but in combination with other products you can get a good suitable dough mix.

Read how to make gluten free chapatti recipes Here. 

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