Editing Food intolerance (section)

==Signs and symptoms==

Food intolerance is more chronic, less acute, less obvious in its presentation, and often more difficult to diagnose than a food allergy.<ref name="pmid10565387">
{{cite journal |author=Vanderhoof JA |title=Food hypersensitivity in children |journal=Current Opinion in Clinical Nutrition and Metabolic Care |volume=1 |issue=5 |pages=419–22 |year=1998 |issn=1363-1950 |pmid=10565387 |doi=10.1097/00075197-199809000-00009}}</ref> Symptoms of food intolerance vary greatly, and can be mistaken for the symptoms of a [[food allergy]]. While true allergies are associated with fast-acting [[immunoglobulin]] IgE responses, it can be difficult to determine the offending food causing a food intolerance because the response generally takes place over a prolonged period of time. Thus, the causative agent and the response are separated in time, and may not be obviously related. Food intolerance symptoms usually begin about half an hour after eating or drinking the food in question, but sometimes symptoms may be delayed by up to 48 hours.<ref name="pmid18594978" />

Food intolerance can present with symptoms affecting the skin, [[respiratory tract]], [[gastrointestinal tract]] (GIT) either individually or in combination. On the skin may include [[skin rashes]], [[urticaria]] (hives),<ref name="pmid12590308">{{cite journal |vauthors=Maurer M, Hanau A, Metz M, Magerl M, Staubach P |title=[Relevance of food allergies and intolerance reactions as causes of urticaria] |language=de |journal=Hautarzt |volume=54 |issue=2 |pages=138–43 |date=February 2003 |pmid=12590308 |doi=10.1007/s00105-002-0481-2 |s2cid=24220704 }}</ref> [[angioedema]],<ref name="pmid12843808">{{cite journal |author=Moneret-Vautrin DA |title=[Allergic and pseudo-allergic reactions to foods in chronic urticaria] |language=fr |journal=Ann Dermatol Venereol |volume=130 Spec No 1 |pages=1S35–42 |date=May 2003 |pmid=12843808 |url=http://www.masson.fr/masson/MDOI-AD-05-2003-130-HS1-0151-9638-101019-ART7}}</ref> dermatitis,<ref name="pmid11298023">{{cite journal |vauthors=Novembre E, Vierucci A |title=Milk allergy/intolerance and atopic dermatitis in infancy and childhood |journal=Allergy |volume=56 |pages=105–8 |year=2001 |issue=Suppl 67 |pmid=11298023 |doi= 10.1111/j.1398-9995.2001.00931.x|s2cid=46144087 }}{{dead link|date=February 2019|bot=medic}}{{cbignore|bot=medic}}</ref> and [[eczema]].<ref name="pmid18971901">{{cite journal |author=Cardinale F |title=[Intolerance to food additives: an update] |language=it |journal=Minerva Pediatr. |volume=60 |issue=6 |pages=1401–9 |date=December 2008 |pmid=18971901 |name-list-style=vanc|author2=Mangini F |author3=Berardi M |display-authors=3 |last4=Sterpeta Loffredo |first4=M |last5=Chinellato |first5=I |last6=Dellino |first6=A |last7=Cristofori |first7=F |last8=Di Domenico |first8=F |last9=Mastrototaro |first9=MF}}</ref> Respiratory tract symptoms can include [[nasal congestion]], [[sinusitis]], [[Human pharynx|pharyngeal]] irritations, [[asthma]] and an unproductive [[cough]]. GIT symptoms include [[mouth ulcer]]s, abdominal cramp, [[nausea]], [[flatulence|gas]], intermittent [[diarrhea]], [[constipation]], [[irritable bowel syndrome]] (IBS),<ref name="pmid16782524">
{{cite journal |vauthors=Ortolani C, Pastorello EA |title=Food allergies and food intolerances |journal=Best Pract Res Clin Gastroenterol |volume=20 |issue=3 |pages=467–83 |year=2006 |pmid=16782524 |doi=10.1016/j.bpg.2005.11.010}}</ref><ref name="pmid16687980">
{{cite journal |vauthors=Pastar Z, Lipozencić J |title=Adverse reactions to food and clinical expressions of food allergy |journal=Skinmed |volume=5 |issue=3 |pages=119–25; quiz 126–7 |year=2006 |pmid=16687980 |doi=10.1111/j.1540-9740.2006.04913.x}}</ref><ref name="pmid18594978">
{{cite journal |vauthors=Ozdemir O, Mete E, Catal F, Ozol D |title=Food intolerances and eosinophilic esophagitis in childhood |journal=Dig Dis Sci |volume=54 |issue=1 |pages=8–14 |date=January 2009 |pmid=18594978 |doi=10.1007/s10620-008-0331-x|s2cid=3076884 }}</ref> and may include [[anaphylaxis]].<ref name="pmid18971901"/>

Food intolerance has been found associated with irritable bowel syndrome and [[inflammatory bowel disease]],<ref name="pmid17206644">
{{cite journal |author=MacDermott RP |s2cid=24307163 |title=Treatment of irritable bowel syndrome in outpatients with inflammatory bowel disease using a food and beverage intolerance, food and beverage avoidance diet |journal=Inflamm Bowel Dis |volume=13 |issue=1 |pages=91–6 |year=2007 |pmid=17206644 |doi=10.1002/ibd.20048|doi-access=free }}</ref> chronic constipation,<ref name="pmid16635922">
{{cite journal |author=Carroccio A |title=Multiple food hypersensitivity as a cause of refractory chronic constipation in adults |journal=Scand J Gastroenterol |volume=41 |issue=4 |pages=498–504 |year=2006 |pmid=16635922 |doi=10.1080/00365520500367400 |name-list-style=vanc|author2=Di Prima L |author3=Iacono G |display-authors=3 |last4=Florena |first4=Ada M. |last5=d'Arpa |first5=Francesco |last6=Sciumè |first6=Carmelo |last7=Cefalù |first7=Angelo B. |last8=Noto |first8=Davide |last9=Averna |first9=Maurizio R.|hdl=10447/10104 |s2cid=24551094 |url=https://iris.unipa.it/bitstream/10447/10104/2/Scand%20J%20Gastroenterol%202006%2041%20498-504.pdf |hdl-access=free }}</ref> chronic hepatitis C infection,<ref name="pmid16632081">
{{cite journal |author=Lang CA |title=Symptom prevalence and clustering of symptoms in people living with chronic hepatitis C infection |journal=J Pain Symptom Manage |volume=31 |issue=4 |pages=335–44 |date=April 2006 |pmid=16632081 |doi=10.1016/j.jpainsymman.2005.08.016 |name-list-style=vanc|author2=Conrad S |author3=Garrett L |display-authors=3 |last4=Battistutta |first4=D |last5=Cooksley |first5=W |last6=Dunne |first6=M |last7=MacDonald |first7=G|doi-access=free }}
</ref> eczema,<ref name="pmid16675339">
{{cite journal |vauthors=Maintz L, Benfadal S, Allam JP, Hagemann T, Fimmers R, Novak N |title=Evidence for a reduced histamine degradation capacity in a subgroup of patients with atopic eczema |journal=The Journal of Allergy and Clinical Immunology |volume=117 |issue=5 |pages=1106–12 |date=May 2006 |pmid=16675339 |doi=10.1016/j.jaci.2005.11.041 |doi-access=free }}
</ref> NSAID intolerance,<ref name="pmid16247191">
{{cite journal |author=Raithel M |title=Significance of salicylate intolerance in diseases of the lower gastrointestinal tract |journal=J. Physiol. Pharmacol. |volume=56 |pages=89–102 |date=September 2005 |pmid=16247191 |url=http://www.jpp.krakow.pl/journal/archive/0905_s5/pdf/89_0905_s5_article.pdf |name-list-style=vanc |author2=Baenkler HW |author3=Naegel A |display-authors=3 |last4=Buchwald |first4=F |last5=Schultis |first5=HW |last6=Backhaus |first6=B |last7=Kimpel |first7=S |last8=Koch |first8=H |last9=Mach |first9=K |issue=Suppl 5 |access-date=14 April 2009 |archive-url=https://web.archive.org/web/20090326175200/http://www.jpp.krakow.pl/journal/archive/0905_s5/pdf/89_0905_s5_article.pdf |archive-date=26 March 2009 |url-status=dead}}
</ref> respiratory complaints,<ref name="pmid9543285">
{{cite journal |vauthors=Woods RK, Abramson M, Raven JM, Bailey M, Weiner JM, Walters EH |title=Reported food intolerance and respiratory symptoms in young adults |journal=Eur. Respir. J. |volume=11 |issue=1 |pages=151–5 |date=January 1998 |pmid=9543285 |doi= 10.1183/09031936.98.11010151|doi-access=free }}
</ref> including asthma,<ref name="pmid17490952">
{{cite journal |vauthors=Maintz L, Novak N |title=Histamine and histamine intolerance |journal=Am J Clin Nutr |volume=85 |issue=5 |pages=1185–96 |year=2007 |pmid=17490952 |doi=10.1093/ajcn/85.5.1185|doi-access=free }}</ref> [[rhinitis]] and headache,<ref name="pmid18649066">
{{cite journal |vauthors=Böttcher I, Klimek L |title=[Histamine intolerance syndrome. Its significance for ENT medicine] |language=de |journal=HNO |volume=56 |issue=8 |pages=776–83 |date=August 2008 |pmid=18649066 |doi=10.1007/s00106-008-1793-z |s2cid=39347593 }}
</ref><ref name="pmid9012205">
{{cite journal |author=Götz M |title=[Pseudo-allergies are due to histamine intolerance] |language=de |journal=Wien Med Wochenschr |volume=146 |issue=15 |pages=426–30 |year=1996 |pmid=9012205 }}
</ref> [[functional dyspepsia]],<ref name="pmid16918725">
{{cite journal |vauthors=Feinle-Bisset C, Horowitz M |title=Dietary factors in functional dyspepsia |journal=Neurogastroenterol. Motil. |volume=18 |issue=8 |pages=608–18 |date=August 2006 |pmid=16918725 |doi=10.1111/j.1365-2982.2006.00790.x |s2cid=22115920 }}
</ref> [[eosinophilic esophagitis]]<ref name="pmid18594978"/> and ear, nose and throat (ENT) illnesses.<ref name="pmid18649066"/><ref name="pmid14743781">
{{cite journal |author=Gordon BR |title=Approaches to testing for food and chemical sensitivities |journal=Otolaryngol. Clin. North Am. |volume=36 |issue=5 |pages=917–40 |date=October 2003 |pmid=14743781 |doi= 10.1016/S0030-6665(03)00059-8}}
</ref>