Patients suffering from chronic congestion, joint pains, irritable bowel syndrome, fatigue, abdominal pain, depression or any symptom with a negative impact on health may consider performing an elimination diet, one of the more accurate ways to determine the presence of food intolerance. The 11 steps listed below are a guide to properly practicing this strategy.

  1. Consult with a physician. Have a patient history and physical performed, focusing on the current symptom complex. Investigate possible causes and consider food intolerance as one of them. Discuss formal allergy testing, especially if immediate hypersensitivity to foods, or celiac disease, is suspected.
  2. Learn. Develop an understanding of the common food groups that cause food intolerance. Read the articles on Eliminating Dairy, Eliminating Gluten, and the Strict Elimination Diet.
  3. Record. For 3-5 days, keep a food diary. Record all the foods you eat, organized by the time of day in one column, and a record of symptoms with details and some type of severity rating scale in a separate column.
  4. Ask.What foods do I eat the most?What foods do I crave?What foods make me feel better?Which foods will be difficult to give up?
  5. Review. Start with the foods that were answers to the questions above, as these are likely problem foods. Now review the food diary to find out if there is any association between these foods and symptoms. Understand that it’s usually not an obvious connection, as food intolerance may take hours or even days to develop.
  6. Decide. After thorough review of common offenders and the personal food diary, generate a list of potential problematic food groups. Make the list as long as it needs to be, with the most likely culprits at the top. Decide the best way to go about eliminating these foods, taking into account your ability to actually succeed. Don’t develop a diet so restrictive that you will not follow through. You may want to start with the top one or two groups on the list. If your current symptoms are significant, a strict elimination diet might be what you want.
  7. Prepare. Clear the house of all sources of the eliminated foods. Read labels. You might want to consider having other members of the household follow the diet as well. It can only improve success and the chances are fair that they are suffering from some of the same intolerances. Avoid going out to eat and ensure that your food environment can be controlled during this time. Choose natural, organic foods as much as possible.
  8. Avoid. Follow your chosen elimination diet for two full weeks. Make no exceptions. The first 2-3 days can be the most difficult, as symptoms may flare. Realize that you are doing this to improve your health and continue to be strong. If serious symptoms emerge, contact your physician.
  9. Challenge. After 14 days, it’s time to challenge your system to see if any of these foods cause symptoms to return. If you have no symptom relief, you may consider moving onto other food groups on your list or give it another week. You will only challenge one food at a time, and it’s best to keep a journal of this phase. Each challenge phase follows this regimen:Day 1: Add the challenge food back into the diet in the morning. If there are no symptoms, continue to challenge with this food by eating it with lunch and dinner. During the challenge phase, your original symptoms can occur, or new symptoms might develop. Listen to your body.Day 2: Eliminate the challenge food. Continue to record any symptoms.Day 3: Continue on elimination diet and record any symptoms.Day 4: If you had no symptoms during this time, you are most likely not intolerant to this food and it can be a part of your diet. Be certain not to start eating this food again until all challenges are completed. Move down your list and repeat days 1-4 until all foods have been challenged.
  10. Repeat. Return to your original list and consider eliminating other potential problem foods through the same process. If you’re satisfied with the success you’ve had, continue on to your “new diet.”
  11. New diet. Using what you have learned, you can now pattern a diet specifically for you, removed of all foods that you don’t tolerate. Consider working with your physician or a dietician to ensure you get a balance of all nutrients daily, and supplement if needed.

These foods to which you’ve discovered you’re intolerant may not have to be exiled forever. In some cases, patients are able to successfully reintroduce the food in varying levels after avoidance for 4-6 months. Consider repeating challenges at that time.