Symptoms and manifestations of food intolerance.

Abstract Food intolerance (FI) is a less defined and a more heterogenous diagnosis than food allergy. The characterization of symptoms during trials, and relationship to time, meal and events such as provocation, are cornerstones of the diagnosis, which is hampered by the complexity of mechanisms and individual conceptuality of illness. Most cases of food intolerance are seen in general practice or do not seek health care. Nevertheless, a substantial number of patients are refered to hospitals. Variation in frequency of diagnosis may be caused by differences in health care levels, dietary habits and age. General symptoms may occur alone or in combination with symptoms from one or more target organs. Even the double blind provocation may give both false positive and false negative results. Repeat examinations, open provocations or verification by a subsequent follow up on an elimination diet may be needed. Many patients are satisfied with an elimination diet given after provocation. The primary objective, however, is to exclude specific organic or psychosocial explanations, in a multidisciplinary approach to these patients.