You
can’t open a health magazine these days without reading story after story about
gluten.
But while our collective gluten obsession has probably gone a little
overboard, the science on gluten helps underscore the complexity of our
digestive systems and how food-related gut issues emerge.
While there’s no question some
people have an allergy to gluten, which is known as celiac disease,
there’s a great deal of expert debate regarding the existence of “non-celiac
gluten sensitivity”—a condition separate from celiac that’s linked with
abdominal pain, headaches, fatigue, and other symptoms.
Throw in the concept of a food
“intolerance,” and it’s hard to keep all the terminology straight—let alone the
triggers.
“If you have a food allergy,
that means your body makes an antibody reaction in response to a food,” says
Princess Ogbogu, MD, an allergist and internal medicine expert at Ohio State
University. “That antibody causes the body to release histamine, which can lead
to hives, shortness of breath, and other symptoms.” Allergies to milk, eggs, and
shellfish are all common examples.
Food intolerances, on the other
hand, are instances where your digestive system may not produce the enzymes
needed to properly break down a food, or may otherwise react improperly to
certain foods. This is the case for people suffering from lactose intolerance.
Symptoms tend toward abdominal pain, bloating, and diarrhea, and your immune
system’s antibody reactions usually aren’t involved, Ogbogu says. “Food
allergies are less common among adults, while intolerances are very common,”
she explains.
Sensitivities are a third,
harder-to-nail-down category. Your immune system may get involved—though not to
the extent that it does if you have an allergy. A lot of it seems dependent on
the individual, and there may be some overlap with other gut conditions like irritable bowel syndrome and leaky gut. Again, experts are
still sorting all this out.
What causes all these food-related
gut issues to show up in some people and not in others? That’s tricky. Ogbogu
says the human gut is complex, and figuring out how these conditions present is
difficult. But there are a few possible or proven triggers.
Antibiotics
Your gut, as you’ve probably heard, is home to
hundreds of billions of bacteria, which are collectively known as your microbiome.
Those bacteria play a lot of roles in your health, including helping your body
digest food. If you’re taking an oral antibiotic to wipe out a virus or
infection, you’re also wiping out plenty of helpful gut bacteria in the
process, Ogbogu says. And in some cases, that mass die-off can lead to
“temporary problems” with digestion, she says. While it’s a source of debate,
some research has also linked the use of antibiotics in food production to
new-onset allergies.
It makes sense that carpet-bombing your microbiome
with antibiotics could lead to changes in the way your gut digests food. But experts
only recently started to grasp the importance (and delicacy) of the human gut’s
ecosystem of microorganisms. They’re still trying to figure out exactly how
antibiotics and your digestive capabilities interact. If you do need to take an
antibiotic, consider incorporating more probiotic-rich fermented foods into
your diet or taking a probiotic supplement (ideally at night, several
hours after your antibiotic) to help replenish those good gut bugs.
Viruses and infections
Research from the Medical College of Wisconsin has
turned up links between stomach flu-causing viruses like norovirus and
food allergies—at least in mice. In that study, the mice exposed to norovirus
showed a heightened allergic response to egg proteins. Again, details are
murky. But it’s possible that the gut damage resulting from a bad stomach bug
could lead to temporary intolerances or longer-term allergies, the research
suggests.
Tick bites
A tick bite can trigger an allergy to meat.
Yes, you read that right. Suffer a bite from a Lone Star Tick—a type common in
much of the US—and your immune system registers the tick’s saliva as an
intruder. Unfortunately, that saliva may contain a type of carbohydrate called
“alpha-gal.” Alpha-gal is also found in meat. Once your immune system deems
alpha-gal an enemy, you may suffer an allergic reaction whenever you eat animal
flesh.
While this condition, known as alpha-gal syndrome,
is thought to be relatively rare, there are at least known 3,500 cases (and
climbing).
Inflammation
“Newer information now being studied suggests
inflammation in the gastrointestinal tract may in fact have an impact in
modifying the microbiome in the intestine [in ways] that may lead to food intolerance,”
says Clifford Bassett, MD, a clinical assistant professor at New York
University’s Langone Medical Center and a spokesperson for the American College
of Allergy, Asthma and Immunology. The exact causes of chronic GI inflammation
are numerous and, in many cases, hard to identify. But it may turn out that gut
inflammation triggers or exacerbates food-related issues.
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