Food allergies are immune responses of the body to food allergens.

This should not be confused with food intolerance. These include milk and fruit sugar intolerance, as well as gluten (gluten) intolerance in celiac disease, and fat intolerance in exocrine pancreatic insufficiency (weakening of the pancreas' ability to digest).


About 5% of the population (female to male ratio 2:1) suffers from food allergies. Patients with a genetic predisposition have allergic reactions to food ingredients, food additives and undesirable impurities.

Gluten (gluten) intolerance is genetically determined. In Europe, it occurs with a frequency of 1:500 inhabitants, and women are affected more often than men. With intolerance to milk sugar, a congenital deficiency of the lactase enzyme and a secondary acquired deficiency of this enzyme are distinguished. This intolerance affects 20% adults in Europe.
Fat intolerance is often the result of recurring pancreatitis (inflammation of the pancreas).


Prevention of genetically determined diseases is almost impossible.

We also proceed from the fact that the high content of processed and fortified foods and processed foods in our diet is the cause of a large number of food allergies and food intolerances. A good prevention is a healthy balanced diet with enough vegetables and green salad. Food must be freshly prepared.

The topic of current research is the question of whether a positive effect in the prevention of food allergies is possible as a result of treatment with probiotic bacteria in the first months of a child's life.

Impaired fat processing, which is usually associated with recurring pancreatic inflammation, can be prevented by avoiding alcoholic beverages (alcohol consumption is a common cause of pancreatic inflammation along with a genetic predisposition).


Pain and flatulence (bloating in the abdomen), colic and diarrhea immediately after ingestion of intolerable foods are typical symptoms of food intolerance. With this disease, very severe concomitant allergic reactions are possible, up to anaphylactic (allergic) shock.


Diagnosis of lactic acid and fruit sugar deficiency is made by means of a specific H2 breath test.
Violation of fat processing is diagnosed by determining the enzyme elastase in the stool.

Diagnosing food allergies is much more difficult. It is based on the use of a hypoallergenic basic diet of potatoes and rice, gradually introducing a variety of additional food groups and testing for reactions that occur.

As a qualifying screening test, a test for methylhistamine in the urine and determination of allergy indicators in the blood, such as histamine and immunoglobulin E, are performed. Thus, the likelihood of the disease is assessed.

Intolerance to gluten (gluten) is determined by specific laboratory parameters and by using a biopsy of the small intestine (tissue sample) taken during an endoscopic examination.


In the treatment of intolerance to milk and fruit sugar, it is necessary to abandon the corresponding products. This is usually possible after detailed consultation with a nutritionist. In case of intolerance to milk sugar, it may be useful to eat an artificially synthesized lactase enzyme that breaks down milk sugar.

With intolerance to gluten (gluten), celiac disease, it is very important to avoid foods containing gluten, which at the same time is the prevention of cancer.

In case of food allergies, it is necessary, as already mentioned above, to refuse products containing an allergy-provoking factor. This may not be so easy, because just in the finished products there are a variety of allergens.
In this situation, it is important to get detailed qualified advice from a nutritionist. Medical support is provided with the help of antihistamines. In acute shock conditions, cortisone is used.

Recently, more and more attention has been paid to the immune system of the gastrointestinal tract, as well as the intestinal flora. There are numerous possibilities for influencing them, for example, with the help of probiotic bacteria or immunomodulators.

Professor, Doctor of Medical Sciences
Head of the Clinic of Gastroenterology and Internal Diseases
Doctor of Medical Sciences
Head of the Gastroenterology Clinic
Professor, Doctor of Medical Sciences
Руководитель клиники гастроэнтерологии и гепатологии, университетская клиника Эссена