The elimination diet is a diagnostic procedure to determine food intolerances when allergological tests have not allowed sufficient conclusions. In the elimination diet, a food is omitted for days at a time according to a fixed pattern and then reintroduced into the diet in order to be able to attribute reactions of the body to its consumption.
What is the elimination diet?
Allergological tests do not always provide enough information about a food intolerance to one or more foods. A more reliable diagnosis, on the other hand, is possible with the elimination diet. It is divided into two phases, the elimination phase and the provocation phase. During the elimination phase, potentially intolerable foods are eliminated from the diet. Only a few approved foods may be eaten. In this way, the elimination diet ensures that the patient does not react to a food that may still be in the digestive tract. Instead, he eats only foods that he can definitely tolerate, since there are no known intolerances to them. During the elimination phase, it can happen that a lot of weight is lost, which is due to the loss of water. This already indicates that there is an intolerance. As soon as the provocation phase is initiated after a few days, it may become apparent what the patient is intolerant to. In this phase of the elimination diet, one potentially intolerant food is consumed each day. It is important that the consumption take place in the early morning so that the body has a full day to react to each. The patient documents their symptoms and observations over the next few days. Based on this documentation, after the provocation phase, the physician can determine if there are any intolerances to any of the foods tested. The elimination diet lasts about one month through these two phases.
Function, effect, and goals
An elimination diet is used to diagnose intolerances to a number of foods. It is used when other procedures have not provided sufficient information. The patient can also carry it out himself, but the elimination diet is only really meaningful if it has taken place under the observation of the doctor. An elimination diet can detect intolerances to a total of 20 different substances. It can, of course, be extended to include other foods at any time. Typically, the elimination diet tests for intolerance to alcohol, coffee, tea, cow’s milk, soy products, wheat (gluten), citrus fruits, eggs or rice, among others. If the patient reacts with symptoms on the day of the elimination diet when he ate one of these foods, then it can be said quite clearly that this is a reaction of his body to that very food. During both phases of the elimination diet, the patient receives a symptom questionnaire from the doctor, on which the typical signs and symptoms caused by intolerances are noted. The patient can then indicate on a scale of 1-10 the degree to which he or she perceived a symptom, if any, to have occurred. Afterwards, the physician can evaluate the sheet and know what the patient reacted to and whether there may be any correlations. On the one hand, the elimination diet can therefore provide a reliable diagnosis, but it can also provide information for further examinations, for example, to locate cross-allergies or to uncover several parallel intolerances at the same time. Following the elimination diet, these results are used for consultation with a dietitian or nutritionist, as the affected person must naturally react to the diagnosis and change the diet.
Risks, side effects, and hazards
An elimination diet is a relatively low-risk method of detecting intolerances or allergies to certain foods. One risk is that the patient may not perform the elimination diet conscientiously, may misinterpret his or her symptoms, or may not document them adequately. At best, the symptom questionnaire is carried at all times so that a note can be made immediately if a symptom occurs. If this is forgotten, the physician subsequently works with falsified results. Furthermore, in an elimination diet it is important that the foods to be tested are eaten early in the morning.The only exception to this is the test against alcohol, which usually follows on the last day of the elimination diet. This may, of course, be drunk in the evening. However, if the other foods are consumed too late in the day, the patient may already be asleep when symptoms appear, or they may not appear until the next day, when the next food is already being tested. This would also falsify the results. If this happens, at best, the physician should be consulted immediately. This delays the elimination diet by one day and the food eaten too late on the previous day is tested again. A rare danger of the elimination diet is allergies to the foods tested. Any allergy, no matter how mild, poses some risk. This is because it can happen at any time that the body of the affected person reacts unusually violently to contact with the allergen. This may end in shock. In most cases, allergic reactions to a food are already detected during an allergy test, so that they are not even included in the elimination diet. However, if symptoms such as severe redness and itching of the skin, shortness of breath, increased heart rate, and anxiety occur, the patient should go to the emergency room immediately and state that they are on an elimination diet.
