What should you know about tests for food intolerance?

Food intolerance can involve difficulty digesting or processing a food component and is different from an immediate immune reaction. Bloating, abdominal discomfort or diarrhoea may follow particular foods, but infections, medicines, coeliac disease and bowel conditions can cause similar symptoms. A diary should record foods, portions, timing, symptoms and bowel changes. Commercial home panels may not provide a reliable diagnosis and can lead to unnecessary restriction.

Bring your food diary to a clinician. If a food is suspected, a short elimination followed by planned reintroduction may help identify whether symptoms change; this should protect nutritional balance and avoid unnecessary exclusions. Nutrition Counselling can help with substitutions. Do not remove several food groups without guidance, particularly for a child, during pregnancy, or when weight is changing.

Seek prompt review for blood in the stool, persistent vomiting, unexplained weight loss, fever, dehydration, nighttime symptoms or severe abdominal pain. Get emergency help for facial or throat swelling, breathing difficulty, faintness or rapidly spreading hives after food, because that pattern can indicate an allergy rather than intolerance.

Which diagnoses should be excluded first? Is a supervised elimination and reintroduction suitable? How can I maintain calcium, fibre and protein? Would referral for Food Intolerance Testing or nutrition advice help?