Difference between allergy and intolerance

You have to ask in a restaurant what is hidden behind the food because your stomach rebels with certain foods? Are you becoming more and more cautious when trying out new foods? If eating becomes a cramp for you, it could be due to a food intolerance. 

In this article you will learn:

  • How to  recognize incompatibilities
  • How to intolerances and allergies is different 
  • Which foods are often the trigger
  • What the symptoms look like and what can help against them 

More and more people complain about certain foods, e.g. B. milk, bread or garlic , can no longer be tolerated and suffer from abdominal pain and cramps after consuming them. Many even believe that they already know the cause of their symptoms and therefore follow more or less strict diets. According to studies, almost one in five Germans suffers from lactose intolerance, and almost one in three has problems digesting fructose . The latter has even been linked to irritable bowel syndrome.

In celiac disease , which affects around 0.9% of children and adolescents, gluten is intolerant. In the intestine, it causes violent inflammatory reactions, which manifest themselves in severe diarrhea, cramps and pain. 

Allergy or intolerance: what’s the difference?

How can you track down food intolerances and allergies? What should those affected consider? There are hardly any general statements here. In addition, many people are not clear what they are actually suffering from.

In particular, self-assessment and facts often diverge here. In a survey of Berliners, 35% believed in a food-related cause of their symptoms . However, food intolerance was objectively verifiable in only 3.6% of those surveyed. 

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In addition, digestive disorders without organic findings and diseases often occur together – and the latter in turn also favor intolerance. So it is not that easy to infer an illness such as a food allergy or a temporary indigestion based on your symptoms alone. Bacterial colonization of the intestine or certain individual substances can also cause cramp-like abdominal pain.

Overall, however , intolerance rather than allergies are to blame in adults . Symptoms outside of the digestive tract, such as swelling of the mucous membranes or reddening of the skin, can be the first signs of an allergy. Sensitization to certain allergens can be demonstrated by determining specific IgE antibodies in the blood or by skin tests.

An example to illustrate this is strawberries:

A real strawberry allergy would show itself during or shortly after consumption as reddening of the skin, itching or even swelling of the mucous membranes. If there is an intolerance to, for example, too much fructose in the strawberries, symptoms such as stomach pressure, stomach pain, nausea, gas, stomach noises or diarrhea only appear a while after consumption.

Ultimately, however, individual triggers can often only be found by keeping a food diary, an elimination diet or a provocation test .

The determination of an intolerance to lactose, fructose or sorbitol is easier, z. B. with H2 breath tests. After the absorption of these substances, the hydrogen content of the breath rises in the event of intolerance.

You can find more information on specific allergies and intolerances in our articles on fructose  and onion intolerance .

Which foods trigger intolerance?

The main allergens in Europe are wheat, milk, eggs, soy, nuts and seafood . On the other hand, intolerances that are not mediated by the immune system mainly lead to lactose, fructose, sorbitol or an increased sensitivity to gluten or wheat . Avoiding foods containing histamine (e.g. red wine, cheese, tuna, nuts) can also help.

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In particular, “lactose intolerance” , ie problems with digesting milk sugar, seems to be increasing. The lactose intolerance is caused by a deficiency or loss of activity of the enzyme lactase in the mucous membrane of the small intestine – flatulence or abdominal cramps follow. They usually only appear in adulthood, as the enzyme activity weakens with increasing age. The best thing in this case: Avoid lactose and use milk alternatives .

Sour natural yoghurts and certain long-matured cheeses have almost no lactose left due to bacterial fermentation – the green light is given here! Be careful with industrially produced foods such as ready meals or sauces: Lactose is often added to these in order to improve the consistency.

Those affected particularly suffer from the accompanying abdominal pain and cramps. However, small amounts usually do not cause any problems, which is why medicines containing lactose are usually also suitable for people with lactose intolerance. 

How do these symptoms arise and what can help?

Abdominal pain is generally the leading digestive complaint when it comes to food intolerance. The symptoms are often caused by cramps in the muscles of the abdominal organs . Conventional painkillers do not eliminate this cause, but merely suppress the sensation of pain.

Antispasmodics, i.e. antispasmodics such as  butylscopolamine, are a good recommendation in this case. In the current S3 guideline on irritable bowel syndrome, antispasmodics are used for pain therapy in contrast to peripheral analgesics, such as B. ASA or ibuprofen and opioids or opioid agonists, which are used for tumor pain, for example. In the long term, people with food intolerances should avoid the substances that are recognized as critical.

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