Food intolerance due to deficiency of digestive enzymes.

This type of food intolerance is especially common among gastroenterologists..

Deficiency of digestive proteolytic enzymes and hydrochloric acid develops in patients with diseases of the stomach, among which chronic gastritis associated with Helicobacter pylori is most often observed..

With a long course of the disease, atrophy of the main glands of the stomach occurs, a decrease in their secretory activity.

More severe atrophy of the gastric mucosa is observed in autoimmune gastritis..

Diseases of the hepatobiliary system contribute to the deterioration of the hydrolysis and absorption of dietary fats and fat-soluble vitamins, and are also often the cause of involvement in the pathological process of the pancreas, which produces three groups of enzymes: proteases, lipases and amylases.

Deficiency of pancreatic enzymes leads to insufficient hydrolysis of nutrients and provokes symptoms of food intolerance.

Diseases of the small intestine, intestinal dysbiosis, lead not only to a violation of the breakdown of all nutrients (proteins, fats and carbohydrates), but also to a violation of their absorption.

In addition, an increase in the permeability of the small intestine mucosa promotes the absorption of macromolecular compounds with antigenic properties, as well as histamine and tyramine..

Conditions are created for the development of both food allergies and pseudo-allergies. Parasitic diseases and the presence of protozoa in the intestine can play a large role in this process.. According to our observations, giardiasis was often the cause of skin lesions..

A special place as a cause of intolerance to certain foods is occupied by enzymopathies, that is, a congenital or acquired defect in the synthesis of an enzyme in the intestine..

Enzyme deficiency can be absolute, which is the cause of a violent clinical picture of food intolerance (bloating, diarrhea, and in children - developmental delay) or relative, which leads to blurred clinical manifestations..

Most often there is a deficiency of lactase, which breaks down the milk sugar lactose into two monomers - glucose and galactose, while patients do not tolerate milk well.. With trehalase deficiency, trehalose is not broken down, which is the cause of intolerance to fungi.

Insufficient hydrolysis of maltose is due to a reduced synthesis of the enzymes maltase and isomaltase (dyspepsia occurs when eating foods rich in maltose - beer, beets, etc..

According to a number of researchers [Nogaller A. , 1983; Lessof M. , 1986], in 40-100% of patients with food allergies, metabolic disorders, a decrease in enzyme activity, and an increase in the permeability of the mucous membrane of the digestive tract are detected..

Psychogenic food intolerance.

This type of food intolerance is rare and is usually caused by a stressful situation in the past, which was to some extent associated with the intake of specific foods and dishes..

For example, if a child was forced to eat semolina as a child, then this dish may be unbearable for many years.. In one patient, on her wedding day, while eating Olivier salad, roundworms began to come out through her mouth..

After this episode, lettuce disappeared from her diet forever, as habitual vomiting arose at the mere thought of it.. The list of such examples can be long, the treatment of this form of food intolerance should be carried out by a psychotherapist.

Baranovsky.

medbe. en.