Food Intolerances

A woman is holding her stomach experiencing digestive issues or stomach pain after eating.

Food intolerances occur when your body has difficulty digesting certain foods, leading to uncomfortable symptoms such as bloating, abdominal pain, diarrhea, or nausea. Common culprits include lactose, gluten, and certain additives, though individual triggers can vary widely. Unlike food allergies, which involve the immune system, food intolerances primarily affect the digestive system, making dietary management a key component in alleviating symptoms and improving overall well-being.

At Austin Gastroenterology, we understand the challenges that food intolerances can present. We offer comprehensive food intolerance testing and management for your convenience. We invite you to explore more about our dietary recommendations for food intolerances below.

Dairy-Free Diet for Lactose Intolerance

Lactose intolerance is a very common condition. Approximately 30–50 million Americans are lactose intolerant. It is more common among certain ethnicities. Up to 80% of African Americans, 80–100% of American Indians, and 90–100% of Asian Americans are lactose intolerant.

Although lactose intolerance can cause great discomfort, it is not a threat to your health. Most people can learn to adjust their diet to avoid discomfort.

Food and Beverages to Avoid

The most obvious source of lactose is milk. Patients with lactose intolerance should avoid milk, including skim milk, buttermilk, powdered milk, milkshakes, malts, ice cream, cream, and cream substitutes. There are a number of lactose-free milks available on the market, including Silk, Mootopia, lactose-free, and soy milk.

Other lactose-containing foods include cheese, cottage cheese, cream cheese, and sour cream. Patients should also consider avoiding party dips, pudding, custard, salad dressings, and cream soups. Rich casseroles or sauces often contain milk products as well. Occasionally, patients will have difficulty with foods made from milk batter, such as doughnuts, pancakes, rich pastries, or buttermilk bread.

Patients may also try the lactase enzyme. This is a medication available without a prescription to help people digest foods that contain lactose. Tablets are taken with the first bite of dairy food to help break down the lactose in the food being consumed.

Gluten-Free Diet for Celiac Disease and Gluten Intolerance

Celiac disease is a chronic autoimmune condition in which eating gluten, a protein found in wheat, barley, and rye, triggers an immune response that damages the small intestine. Celiac disease affects a very small number of Americans, though many cases go undiagnosed. There are other cases where an individual may just be dealing with a gluten intolerance—not considered a full autoimmune response to gluten consumption, but still results in discomfort for the patient.

Although removing gluten entirely from your diet can be challenging, many people find that, with time and mindful choices, it is entirely manageable.

Food and Beverages to Avoid

The most obvious sources of gluten are foods made from wheat, barley, and rye. These foods include breads and crackers, baked goods, malt beverages, and many processed snacks.

Less obvious, but still important to consider, are foods and drinks in which gluten is often hidden as a thickener, stabilizer, or flavoring. These include soups and broths, gravies, salad dressings, sauces, processed deli meats, flavored snack foods, imitation seafood, and even some candies. Soy sauce is another common source of hidden gluten.

Fortunately, many gluten-free alternatives are now widely available, such as breads and pasta made from rice, corn, quinoa, or other gluten-free grains. Always read product labels carefully and look for certified gluten-free options when possible.

FAQs on Diets for Great Gut Health

We’re seeing more gluten intolerance and allergies than ever before. One reason is that the amount of gluten in wheat products nowadays is substantially higher than it was just 30 years ago. And our bodies aren’t used to it.

First, it’s important to know the difference between gluten intolerance vs. a gluten allergy. They often present similar symptoms, like bloating, a change in bowel habits (such as diarrhea and even constipation). But most people aren’t allergic to gluten. They’re intolerant of it.

A blood test known as a Celiac panel is a very sensitive way to help confirm if you have a true allergy. This test is ideally performed while a patient is still consuming some gluten in their diet. The allergic reaction, or inflammation, is your body’s immune response to the protein in wheat products called gluten. Your body senses this protein as something foreign. That inflammation affects the small bowel (where most nutrients are absorbed) and can ultimately lead to malnutrition, osteoporosis, and even depression.

In addition to malnutrition, chronic inflammation from an active gluten allergy can increase your risk for some cancers, like lymphoma and small bowel cancers. This risk, however, is greatly lessened if the inflammatory process is controlled.

www.celiac.org is a good, peer-reviewed website that offers great recipes and simple food lists.

Taking a probiotic isn’t necessary for everyone. Our bodies need good bacteria (the normal flora) to help finish digestion and reduce inflammation. You actually have more gut bacteria than you have cells in the entire human body. But when the “good bacteria” or normal flora are altered when you take antibiotics, for instance, then we recommend taking a probiotic. There are a lot of exciting studies detailing the benefits and situations for when a probiotic would be beneficial. But for most people, we recommend probiotics:

  • During and after a course of antibiotics to restore good bacteria.
  • Traveling abroad, where your body may be exposed to various changes in your normal flora.

Probiotics do not need to be used chronically, as these are live culture bacteria that should be able to reproduce once established. A typical course of probiotics ranges from 4–6 weeks.

IBS is an extremely common condition; however, many people go undiagnosed.

Classic symptoms of IBS center around a change in bowel habits that may be associated with bloating, pain, constipation, and/or diarrhea.

Symptoms of IBS can often overlap with other serious diseases like inflammatory bowel disease (Crohn’s disease and ulcerative colitis), gluten allergy, and even malignancies. It’s important to rule out other diseases that may present with IBS symptoms, through endoscopic procedures, imaging, and thorough patient history and physical exam.

One dietary plan for IBS that has been quite beneficial is a low FODMAP diet. This dietary plan reduces the intake of foods that contain fermentable sugars. This, in turn, reduces the amount of gas and inflammation that is generated in the gut through the digestive process.

Try and reduce the intake of the following items if you have IBS symptoms:

  • Alcohol
  • Lactose/dairy
  • Fruits high in fructose (sugar)
  • Excessive raw vegetable intake of broccoli, cauliflower, beans, and cabbage
  • Sugar substitutes found in sugarless gum and candy, like sorbitol, mannitol, isomalt, maltitol, and xylitol

This is a tricky one, but lemons and apple cider vinegar are acids. And while acids help break down foods (especially proteins), it is important to remember that increasing acid intake does not help with all “abdominal complaints.” In fact, it can worsen some common symptoms and conditions like ulcer disease, tooth decay, gastritis, and esophagitis (inflammation of the stomach and esophagus).

There is no compelling data available supporting apple cider vinegar use in acid reflux; in fact, it’s counterintuitive to use an acid for acid reflux disease. Some patients do report benefits with apple cider vinegar use, but only when they eat larger meals or meals with increased protein content.

It is not recommended to ingest increased amounts of lemons and apple cider vinegar on a regular basis, although it generally is thought to be safe to try.

The Paleo diet is a popular diet that has gained a lot of attention recently. The Paleo diet is a low-carb diet that favors foods high in animal proteins and avoids the consumption of grains and dairy. While some components of the Paleo diet do help reduce calorie-dense foods such as dairy/processed flour, it does include relatively high amounts of animal fats.

A healthier option would be eating proteins that are plant-based or centered around fish and chicken, rather than red meats (higher-fat meats). It is also important to increase the intake of dark, green leafy vegetables in the diet daily and to have portion control of your meals. Humans are meant to be frequent grazers, and that means ideally consuming small, frequent meals throughout the day. This helps keep our metabolism up and helps regulate our gut hormones, such as insulin.

Balancing the size of meals, caloric intake (counting your calories), and the nutritional content of foods are the cornerstones behind a healthy diet that promotes feeling great and living longer.