Food hypersensitivities and intolerances (excluding allergy and celiac disease)

This article reviews three non-allergic, non-celiac food hypersensitivities and intolerances: non-celiac gluten sensitivity (NCGS), lactose intolerance, and FODMAPs intolerance. It outlines NCGS as a clinical entity lacking diagnostic biomarkers and involving innate immune responses, with prevalence estimates between 0.5–13% and variable individual tolerance thresholds. Lactose intolerance, due to hypolactasia affecting 10–30% of the French population, leads to undigested lactose fermentation, gas production, and osmotic symptoms, diagnosed via hydrogen breath testing and managed with selective lactose restriction. FODMAPs intolerance, often observed in irritable bowel syndrome, involves osmotic and fermentative mechanisms and responds to low-FODMAP diets. The necessity of initial dietary follow-up for implementing these restrictive regimens is emphasized.