Food Allergy and Food Intolerance. Often the two are confused with each other.

With my current interest of increasing awareness and knowledge of the Splanchnic Inflammatory Syndrome, which represents the imaging findings of the Metabolic Syndrome and its precursors of Irritable Bowel Syndrome, Leaky gut, and maybe many other subtypes.

An individual has splanchnic inflammatory syndrome by observing the combination of fatty liver and increased upper digestive tract enhancement (or mural fluid content on DWI)) on GBCA enhanced MRI studies of the abdomen,. Many conditions in the splanchnic system reflects this chronic inflammation of the pan-splanchnic system, from acute acalculous cholecystitis, mesenteric panniculitis, and tiny pancreatic cysts. I report in the impression that this often reflects a food allergy or food intolerance. The first step to treatment is to make alterations in diet. As a classically trained allopathic physician historically I have been skeptical of stories of individuals with gross obesity, severe type II diabetes, heart disease, cognitive impairment, and they just switched foods they ate, and paid attention to maintaining that diet, and had then overcame their ills... I now believe that can happen happen for a number of individuals. Also I find it somewhat also with dark humor in the fact that with increasingly perplexing diseases and conditions, one of the first recommendations of experts to ward off serious malady is to eat a healthy diet, which globally could be termed an autoimmune diet. This has been described for the increasing number of varied types of COVID infection, to CRPS, to fibromyalgia.... to basically everything.

The classic food allergy is the reaction to nuts, notably the peanut, where the food entity causes an allergic response - which means it excites the immune system, which can react all the way from itchiness and hives to anaphylactic shock and death. The classic food intolerance is to milk, where individuals respond with various digestive system reactions (abdominal pain, GE reflux, nausea, vomiting, bloating, diarrhea) because these individuals are deficient in the enzyme lactase which breaks down the lactose in milk, and the un-metabolized lactose results in those symptoms. The other classic food intolerance is to ETOH (alcohol), where individuals flush, feel sick, nauseous, confused, even after one alcoholic beverage, This is because they lack (sufficient) alcohol dehydrogenase to metabolize alcohol. So food intolerances generally reflects deficiency of a metabolic pathway/ enzyme. This is in contrast to an allergy, which elicits an immune reaction, of varying severity. Gluten-sensitivity also is most often an intolerance, rather than an allergy. Many of the food reactions we experience are likely along the lines of an intolerance.In my case, over recent years garlic gives me digestive system symptoms of abdominal pain and mild nausea, which likely reflects intolerance rather than allergy.

In short, allergies can kill you, intolerance gives you digestive system upsets of various kinds (abdominal pain, reflux nausea, vomiting, bloating, diarrhea).

In an upcoming blog I will describe the importance of paying attention to your body's responses to various foods.... and trust that it knows what it is doing. This is likely the important key to successfully dieting and health.

Richard Semelka, MD