Sarah is a recent client we have had at The Food Treatment Clinic and hopefully by sharing her story it will illustrate how seeing a dietitian could help you.
Background
Sarah came to see us complaining of digestive health problems which had started many years ago. She reported a self-diagnosed lactose intolerance and said that despite avoiding lactose, she had random periods of severe diarrhoea with constant bloating.
Sarah’s symptoms were ruining her life as they were so unpredictable and she had often had to cancel meals out or take time off work.
Assessment
During her first dietitian appointment, Sarah reported that she had been accurately diagnosed with IBS 3 years ago (e.g. the correct bloods tests had been done whilst eating gluten).
Sarah’s diet showed that she ate regularly, avoided caffeine, had a good fibre intake, exercised regularly and drank plenty of fluid. All of the things you would need to address as a ‘first line’ in IBS.
Sarah did have some levels of stress in her life but these were fairly minor and did not seem to coincide with her symptoms.
Intervention
Sarah was trialled on a 100% milk free diet, ensuring that calcium requirements were still being met.
1 Week In
Sarah no longer had any diarrhoea, but still had some bloating. She was then started on a specific probiotic as it wasn’t surprising that her gut microbiota would be affected from years of diarrhoea.
4 Weeks In
Sarah had no symptoms at all. She was then started on a reintroduction phase to confirm a cow’s milk protein allergy.
5 Weeks In
Sarah managed to get 2 days into the reintroduction before severe diarrhoea confirmed a non-IgE mediated cow’s milk allergy,
Now
Sarah is symptom free, no longer needs to take a probiotic and is enjoying dairy free alternatives. The dietitian also provided her with information to support label reading, eating out and ensuring that she does not become calcium deficient.
Q & A
Why did Sarah’s doctor not pick this up?
Food allergies are rare and there is actually no test for a non-IgE mediated allergy. You would need to work with a specialist such as a dietitian.
Why did Sarah still have symptoms on a lactose free diet?
If you have a lactose intolerance you only need to avoid foods which are high in lactose e.g. milk, ice-cream and yoghurt. However, Sarah was still eating foods such as butter, cheese and dark chocolate – these foods all contain milk proteins which will trigger a milk allergy.
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