Food Sensitivity or is it really a Gut Problem? Why Removing Foods May Not Be the Answer

If you regularly experience bloating, changes in bowel habits, reflux, abdominal discomfort, headaches, fatigue or skin issues such as eczema, it's easy to start wondering whether a particular food is responsible.

Perhaps you've noticed that certain foods don't seem to agree with you. Maybe you've already removed gluten or dairy and felt a little better. Or perhaps your list of foods you're avoiding is gradually getting longer, yet you still don't feel that you've got to the bottom of what's going on.

With so many food sensitivity tests now available, testing can seem like the obvious next step.

But before removing food after food from your diet, it's important to understand the difference between a food allergy, a food intolerance and a food sensitivity. It's also worth asking another question:

Is the food really the problem, or could something else be happening within my digestive system?

Food allergy, food intolerance or food sensitivity?

These terms are often used interchangeably, but they describe different types of responses. Understanding the distinction matters when deciding what needs investigating.

Food allergy

A food allergy involves the immune system and can cause a rapid and potentially serious reaction. Symptoms may include swelling, hives, breathing difficulties, vomiting or, in severe cases, anaphylaxis. If you suspect that you've a food allergy, this needs proper medical assessment. A home food sensitivity test isn't a substitute for allergy testing or advice from your GP.

Food intolerance

A food intolerance is different. It doesn't involve the same immediate immune response as an allergy. Instead, it may occur when the body has difficulty digesting or processing a particular food or component of a food. Lactose intolerance is a familiar example: if there's insufficient lactase, the enzyme needed to break down lactose, undigested lactose can pass into the large intestine where it's fermented by gut bacteria. This can lead to symptoms such as gas, bloating, abdominal discomfort and diarrhoea.

Symptoms may not appear immediately and the amount of a food someone can tolerate can vary considerably from person to person.

Food sensitivities

Food sensitivities are often less straightforward. The term is generally used when a particular food appears to aggravate symptoms, but the relationship between the food and the symptoms isn't always clear cut. Symptoms may be delayed and can include digestive symptoms, headaches, fatigue or skin issues.

This is where things can become confusing, particularly when it comes to food sensitivity testing.

What are food sensitivity tests actually measuring?

Many of the food sensitivity tests available, particularly home finger prick tests, measure IgG antibodies to foods.

The difficulty is that finding IgG antibodies to a food doesn't automatically mean that you're intolerant or sensitive to it. IgG can simply reflect exposure to foods that you eat regularly and the way your immune system recognises them.

This can sometimes result in a report showing reactions to a long list of foods, including foods that you've been eating regularly without any obvious problem.

If you then remove everything on that list, you can quickly end up with nothing left on your plate while still having no clear idea what was actually causing your symptoms.

That's why the type of food sensitivity test being used, what it measures and, most importantly, how the results are interpreted all matter.

Some tests look at a broader range of immune responses rather than IgG alone and may provide more useful information when there is a clear reason to investigate whether particular foods are contributing to symptoms. Tests such as FIT176 and P88 are blood tests that go a step further than a standard IgG panel, looking at more than one kind of immune response rather than IgG alone, so rather than just showing that your immune system has met a food, they give a fuller picture of whether that food's actually provoking a reaction. You have a shorter, more trustworthy list that you can act on.

But even when food sensitivity testing gives us useful information, it doesn't explain why those foods have become problematic in the first place. And this is the part that I see being missed.

An important question to ask is: why have those foods become problematic in the first place?

Could your gut health be affecting how you respond to food?

Understanding what's happening within the gut can be just as important as identifying individual food triggers.

Your digestive system is much more than a tube that food simply passes through. Digestion and absorption, the gut microbiome, gut lining health, inflammation and immune activity can all influence how your body responds to the food you eat.

This is also why your tolerance to a particular food can sometimes change.

You may have eaten something regularly for years without any problems and then suddenly find that it causes bloating, discomfort or changes in your bowel habits. The food itself may not have changed, but something within your digestive system may have.

Factors that can influence gut health and food tolerance can include:

• changes in the gut microbiome

• digestive dysfunction

• inflammation

• stress

• poor sleep

• illness

• nutrient deficiencies

• certain medications

• previous infections

• antibiotic use

When the digestive system is struggling, continually removing more foods will leave you with an increasingly restrictive diet without addressing what's driving the problem in the first place.

When is stool testing useful?

This is where comprehensive stool testing can sometimes become an important part of the picture. Food sensitivity testing and stool testing are looking at different things.

A food sensitivity test investigates your response to particular foods, whereas a comprehensive stool test looks at what's happening within the digestive system itself:

• digestion and absorption

• inflammation

• the gut microbiome

• immune activity within the gut

• infections or other microbial findings

Comprehensive stool tests such as GI360 or GI Effects can provide information that you simply cannot get from symptoms alone. They help us to investigate whether you're digesting and absorbing food effectively, whether there are signs of inflammation and what your gut microbial balance looks like.

This matters because identifying a food trigger doesn't necessarily resolve the underlying problem.

If your digestion is impaired, your gut microbiome is disrupted or there are other factors affecting the digestive environment, simply removing another food is unlikely to address those underlying issues.

It is not about removing more and more foods

If you have already removed gluten, dairy, eggs or other foods and you're still experiencing symptoms, the answer isn't to keep removing more.

Sometimes testing can be extremely useful because it gives us information that we cannot get from symptoms alone. In some cases, I may prioritise investigating gut health before considering food sensitivity testing. In others, your health history and symptoms may be enough to guide the next steps without testing at all.

What matters is understanding your individual picture and having a reason for the approach being taken.

The aim is to understand what is driving your symptoms

The goal isn't to create a long list of foods that you can no longer eat.

It's to understand what may be driving your symptoms, support the health and function of your digestive system and work towards a varied diet that you can enjoy without constantly worrying about what you've eaten.

If you're experiencing ongoing bloating, changes in your bowel habits, reflux, reactions to certain foods or other unexplained digestive symptoms, and you feel as though you're continually removing foods without getting to the bottom of the problem, it may be time to look more closely at what's happening within your gut.

Sometimes the food is part of the picture.

But sometimes, the more important question is what's happening in your gut when that food arrives?

If this resonates with you, you're welcome to book a discovery call. It's a gentle first step to explore how we can begin to address your symptoms. Click on the link below.

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