Editing Food intolerance (section)

==Management==
Individuals can try minor changes of diet to exclude foods causing obvious reactions, and for many this may be adequate without the need for professional assistance. For reasons mentioned above foods causing problems may not be so obvious since food sensitivities may not be noticed for hours or even days after one has digested food. Persons unable to isolate foods and those more sensitive or with disabling symptoms should seek expert medical and dietitian help. The dietetic department of a [[teaching hospital]] is a good start.

Guidance can also be given to your general practitioner to assist in diagnosis and management. Food [[elimination diet]]s have been designed to exclude food compounds likely to cause reactions and foods commonly causing true allergies and those foods where [[enzyme deficiency]] cause symptoms. These [[elimination diet]]s are not everyday diets but intended to isolate problem foods and chemicals.

It takes around five days of total abstinence to unmask a food or chemical, during the first week on an [[elimination diet]] withdrawal symptoms can occur but it takes at least two weeks to remove residual traces. If symptoms have not subsided after six weeks, food intolerance is unlikely to be involved and a normal diet should be restarted. Withdrawals are often associated with a lowering of the threshold for sensitivity which assists in challenge testing, but in this period individuals can be ultra-sensitive even to food smells so care must be taken to avoid all exposures.{{Citation needed|date=May 2014}}

After two or more weeks if the symptoms have reduced considerably or gone for at least five days then challenge testing can begin. This can be carried out with selected foods containing only one food chemical, to isolate it if reactions occur. In Australia, purified food chemicals in capsule form are available to doctors for patient testing. These are often combined with [[placebo]] capsules for control purposes.{{Citation needed|date=May 2014}} This type of challenge is more definitive. New challenges should only be given after 48 hours if no reactions occur or after five days of no symptoms if reactions occur.

Once all food chemical sensitivities are identified a [[dietitian]] can prescribe an appropriate diet for the individual to avoid foods with those chemicals. Lists of suitable foods are available from various hospitals and patient support groups can give local food brand advice. A dietitian will ensure adequate nutrition is achieved with safe foods and supplements if need be.

Over a period of time it is possible for individuals avoiding food chemicals to build up a level of resistance by regular exposure to small amounts in a controlled way, but care must be taken, the aim being to build up a varied diet with adequate composition.<ref name = "Clarke" /><ref name="pmid17206644" /><ref name="pmid16635922" /><ref name="pmid9196849"/><ref name="pmid10972377">
{{cite journal |author=Jacobsen MB |title=Relation between food provocation and systemic immune activation in patients with food intolerance |journal=Lancet |volume=356 |issue=9227 |pages=400–1 |year=2000 |pmid=10972377 |doi=10.1016/S0140-6736(00)02536-8 |name-list-style=vanc|author2=Aukrust P |author3=Kittang E |display-authors=3 |last4=Müller |first4=F |last5=Ueland |first5=T |last6=Bratlie |first6=J |last7=Bjerkeli |first7=V |last8=Vatn |first8=MH|s2cid=24311710 }}</ref><ref name="pmid9577245">
{{cite journal |author=Gaby AR |title=The role of hidden food allergy/intolerance in chronic disease |journal=Alternative Medicine Review |volume=3 |issue=2 |pages=90–100 |year=1998 |pmid=9577245 }}</ref><ref name="pmid17229899">
{{cite journal |vauthors=Drisko J, Bischoff B, Hall M, McCallum R |title=Treating irritable bowel syndrome with a food elimination diet followed by food challenge and probiotics |journal=J Am Coll Nutr |volume=25 |issue=6 |pages=514–22 |year=2006 |pmid=17229899 |doi=10.1080/07315724.2006.10719567|s2cid=9314332 }}</ref>