FOOD AVERSION

Food aversion –the only non-controversial term in this list – means dislike and avoidance of a particular food for purely psychological reasons.

These definitions are ones that the majority of mainstream doctors practising in this field would feel reasonably happy with. But bear in mind, if comparing this book with other books or articles, that the same words may be used in an entirely different way. It is also important to remember that they are theoretical definitions, and there is a sizeable gap between theory and practice when it comes to diagnosing individual patients. In practice the designation of an illness as ‘food allergy’ or ‘food intolerance’ would not depend so much on skin-prick tests or other tests as on the type of symptoms that the patient shows. If the symptoms are among those traditionally associated with allergy, such as asthma or urticaria, and if foods are shown to be responsible, then the condition will probably be labelled as food allergy, even if skin-prick tests are negative, as they sometimes are in such cases. If, on the other hand, the symptoms are not of the allergic kind – as in Susan’s case – then the label ‘food intolerance’ will be used. Skin-prick tests will not normally be carried out because they are most unlikely to give a positive result, so they will not contribute much to the diagnosis.

In theory, then, the distinction between allergy and intolerance is based on causes. In the doctor’s surgery, however, the distinction is likely to be based on symptoms, because it is known that asthma or urticaria are probably true allergic reactions, while migraine or depression are not. With a symptom such as diarrhoea, the cause might be an allergic reaction, an intolerant one, or something else entirely. In such cases, special tests would be needed to make a diagnosis of ‘food allergy’.

Where patients show a collection of symptoms that include, say, asthma and migraine, the diagnosis is more difficult. If all these symptoms clear up at once when certain foods are avoided, is it allergy or is it intolerance? This is not a question that can be easily answered at present, and for the purposes of this book we will use the umbrella term ‘food sensitivity’ to cover such situations.

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