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What's the Difference Between a Food Allergy and a Food Intolerance?

What is the difference between food allergies and food intolerances?
Elaine

A food intolerance means either the body can't properly digest the food that is eaten, or that a particular food might irritate the digestive system. Symptoms of food intolerance can include nausea, gas, cramps, belly pain, diarrhea, irritability, or headaches.

A food allergy happens when the body's immune system, which normally fights infections, sees the food as an invader. This leads to an allergic reaction — an immune system response in which chemicals like histamine are released in the body. The reaction can cause symptoms like hives, vomiting, belly pain, throat tightness, hoarseness, coughing, breathing problems, or a drop in blood pressure.

Even if previous reactions have been mild, someone with a food allergy is always at risk for the next reaction being life-threatening. Eating a microscopic amount of the food could lead to anaphylaxis. So anyone with a food allergy must avoid the problem food(s) entirely and always carry emergency injectable epinephrine.

People with food sensitivities, on the other hand, might be able to ingest a small amount of the bothersome food without a problem.

Medically reviewed by: Larissa Hirsch, MD
Date reviewed: January 2021