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SYMPTOMS THAT HAVE BEEN REPORTED IN FOOD INTOLERANCE: ULCERATIVE COLITIS

Many other symptoms have been attributed to food intolerance over the years. Those discussed below are ones that are mentioned fairly regularly in connection with food.

Ulcerative colitis

Ulcerative colitis is an inflammatory disease that affects the large intestine (also called the colon – hence colitis, inflammation of the colon). It causes bouts of abdominal pain and diarrhoea, often with blood and mucus in the stools. There were reports in the 1960s and 1970s that ulcerative colitis patients ‘recovered’ on a milk-free diet, and this was attributed to food intolerance. But subsequent experience has not borne this out.

Dr John Hunter, who pioneered the study of food intolerance in Crohn’s disease, has had little success in treating ulcerative colitis by the same methods. When all food is withdrawn, and elemental diets or intravenous feeding used instead, the ulcerative colitis patients do not make a sustained recovery’. Perhaps the milk-free diets in the original studies seemed to be effective because the patients were short of lactase, the enzyme that breaks down milk sugar. Diarrhoea often makes the gut deficient in

lactase temporarily, and by drinking milk the patients may have been perpetuating their attacks of colitis.

One form of ulcerative colitis, known as proctitis, produces inflammation mainly in the lower part of the large intestine, near where it opens at the anus. It is possible that food allergy7 plays a part in this disorder, as a great many IgE antibodies have been found in the vicinity. So far, however, there has been little investigation of this possibility.

There is one type of colitis which is commonly due to food, and that is infant colitis, especially when if affects children under a year old. This rare condition is regarded as a form of ulcerative colitis by some doctors, but not by others. The main symptom is diarrhoea containing blood and mucus. A sample is taken and examined under the microscope (a biopsy) to assess the degree of inflammation in the gut. Dr Peter Milla, of the Institute of Child Health in London, has made a special study of infant colitis, and finds that the symptoms are caused by food in about 75 per cent of cases. There are clear signs of immune-system involvement, so this is in fact food allergy. In some babies, IgE and mast cells are involved, in others it is a different type of immune reaction.

This condition is known as food-allergic colitis or FAC and most of the babies suffering from it are are bottle-fed. However, some are breast-fed infants responding to foods that the modier is eating. For bottle-fed infants, switching to a hydrolysate feed (see p213)is the usual treatment. For those being breast-fed, it is usually enough for the mother to eliminate certain foods from her diet – the most common culprits being milk, egg, soya and wheat. Where this alone does not work, the mother can also be treated with the drug, sodium cromoglycate to reduce absorption of intact food molecules by suppressing her own allergic reactions to them. Some babies are best treated by taking them off the breast and giving a hydrolysate feed instead.

A few babies with colitis have a type of autoimmune disease – they are making antibodies to their own cells. These antibodies start to attack various body cells, including those in the large intestine, and this sets off the inflammation that causes the bleeding and diarrhoea. By looking for autoantibodies in the blood, doctors can tell if colitis is being caused in this way. Interestingly enough, Dr Milla has found that changing to a hydrolysate feed or chicken-based feed helps these babies considerably. Some still need im-muno-suppressant drugs to control the inflammation, but others do not. It would seem that immune reactions to foods are aggravating the autoimmune reaction in such cases. Some babies with food-allergic colitis grow out of it, but others are still sensitive to the same foods five or more years later. For other causes of diarrhoea in babies and children.

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