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Considering histamine in functional gastrointestinal disorders.

Wolfgang J Schnedl1, Dietmar Enko2

  • 1General Internal Medicine Practice, Bruck, Austria.

Critical Reviews in Food Science and Nutrition
|July 10, 2020
PubMed
Summary

Many people experience food intolerance and malabsorption, often linked to carbohydrates, proteins, or histamine. Histamine intolerance should be considered in diagnosing gastrointestinal issues.

Keywords:
Histaminediamine oxidasefood intolerancefood malabsorptionfructoselactosemastozytosis

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Area of Science:

  • Gastroenterology
  • Clinical Nutrition
  • Immunology

Background:

  • Adverse food reactions affect up to 20% of the population in westernized countries.
  • Functional gastrointestinal complaints are frequently linked to malabsorption of carbohydrates, proteins, and biogenic amines.
  • Histamine intolerance is often overlooked in the differential diagnosis of these conditions.

Purpose of the Study:

  • To review current differential diagnoses and diagnostic tests for food intolerance and malabsorption.
  • To emphasize the importance of including histamine intolerance in the diagnostic workup for functional gastrointestinal complaints.
  • To provide an overview of diagnostic approaches for various food intolerances.

Main Methods:

  • Literature review of differential diagnoses for food intolerance and malabsorption.
  • Analysis of diagnostic tests for carbohydrate, protein, and biogenic amine intolerance.
  • Discussion of the role of histamine in gastrointestinal and extra-intestinal symptoms.

Main Results:

  • Food intolerance/malabsorption involves inadequate degradation or absorption of dietary components.
  • Symptoms are variable, functional, nonspecific, and can be gastrointestinal or extra-intestinal.
  • Current diagnostic approaches often do not include evaluation for histamine intolerance.

Conclusions:

  • Histamine intolerance is a significant, yet frequently missed, cause of functional gastrointestinal symptoms.
  • A comprehensive diagnostic workup should consider histamine intolerance alongside other food intolerances.
  • Targeted dietary interventions are crucial for managing food intolerance and malabsorption.