Journal
CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION
Volume 61, Issue 17, Pages 2960-2967Publisher
TAYLOR & FRANCIS INC
DOI: 10.1080/10408398.2020.1791049
Keywords
Histamine; lactose; fructose; diamine oxidase; food intolerance; food malabsorption; mastozytosis
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In western countries, a significant portion of the population may experience adverse reactions to certain food components, leading to various gastrointestinal issues. Thus, a thorough diagnostic workup is necessary for managing patients with functional gastrointestinal complaints, including consideration of individual tolerance to different food components.
In westernized countries, adverse reactions to ingested foods are reported to affect up to 20% of the population. Functional, nonspecific, non-allergic gastrointestinal complaints are mainly due to the intolerance/malabsorption of carbohydrates (lactose and fructose), proteins (gluten), and biogenic amines (histamine). Food intolerance/malabsorption is defined by one or several of the above mentioned food components not being degraded and/or absorbed properly within the gastrointestinal tract. Food intolerance/malabsorption causes variable, functional, nonspecific, non-allergic gastrointestinal and extra-intestinal complaints, and a detailed diagnostic workup for all possible etiologic factors in individual patients is essential. Usually, evaluation for histamine intolerance is not included in differential diagnoses of patients with functional, nonspecific, non-allergic gastrointestinal complaints. A targeted dietary intervention for single or possibly combined intolerance/malabsorption is required. In this article, we review currently discussed differential diagnoses and available tests for intolerance/malabsorption. Accordingly, we aim to outline why including histamine and, histamine intolerance, should be considered in differential diagnoses of patients with functional, nonspecific, non-allergic gastrointestinal complaints.
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