Have trouble eating certain foods as you age? Here’s what you can do.

Do some foods that you used to enjoy suddenly no longer agree with you? Do you often experience bloating, cramps, and pain that can vary in severity and duration and that come and go for no apparent reason? If so, you may have a food sensitivity, a digestive issue that becomes common as people age.

“Food sensitivity is simply a sign your digestive system is changing,” says Dr. Alessio Fasano, director of the Center for Celiac Research and Treatment at Harvard-affiliated Massachusetts General Hospital. “It can be physically unpleasant at times, but there are ways to manage this change without affecting your overall diet and ensure you keep getting the vital nutrients you need.”

What’s in a name?

Many people confuse a food sensitivity with a food intolerance or allergy. While these conditions share many common symptoms, they are quite different. Here’s a look at each one.

Food sensitivity. This is an individual’s adverse physical response to a certain food, beverage, or ingredient. The symptoms might be only digestive problems, such as abdominal pain, bloating, and gas.

However, you may also have fatigue, headache, or “brain fog.” For example, some people have digestive problems and other symptoms after eating too much gluten, a protein found in wheat, barley, and rye. This is different from celiac disease, caused by an immune reaction to gluten that requires complete avoidance of the protein.

Food intolerance. An intolerance means you lack the enzymes needed to break down and absorb certain ingredients. The inability to digest lactose, the sugar in dairy products, is a common food intolerance. When lactose is not absorbed, it ferments in the colon and leads to symptoms like gas, bloating, nausea, and intestinal pain.

Food allergy. An allergy is the most serious of the three conditions. It occurs when the body mistakes a food ingredient as harmful and defends itself by producing high levels of a type of antibody called immunoglobulin E. Sometimes a food allergy is life-threatening and requires immediate medical attention. The most common food allergies are to shellfish, nuts, fish, and eggs. A person with a food allergy may have symptoms similar to an intolerance or sensitivity, but he or she also can experience hives, throat swelling, and shortness of breath.

A weakening wall

Of the three, food sensitivity is the most common as you age, says Dr. Fasano. He suggests that the major factor is a natural “weakening” of our intestinal lining that leads to tiny leaks.

One way to look at this change is to picture your gut like a castle wall built to protect against invaders like bacteria, viruses, and parasites.

As you age, this wall can weaken, and spaces develop between the seams. This allows more invaders to sneak in, which can trigger inflammation and cause all kinds of digestive problems. Changes in everyday diet can further weaken your wall’s structure — for instance, if you eat high amounts of fried and processed foods. Quantity is also an issue. “Your digestion often can’t handle the same portions as when you were younger,” says Dr. Fasano.

Sensitivity training

There are ways to manage a food sensitivity and keep your digestive system healthy. The first step is to identify the problem foods. You may have a good idea which foods are the troublemakers, but your sensitivity also could be caused by combinations of foods or even certain amounts.

The best approach to manage food sensitivity is to adopt a short-term elimination diet. It works like this: You eliminate a particular food for about two to four weeks to see if your symptoms recede. Then you reintroduce the food gradually, according to your tolerance, to see if your symptoms reappear.

“Elimination diets are trial-and-error, and you may have to try different foods and amounts until you find the right combination,” says Dr. Fasano.

While it’s possible to follow an elimination diet on your own, Dr. Fasano recommends consulting with a nutritionist or dietitian.

“These professionals can guide you through the process and help you track your progress, as well as offer support tools like creating a food diary and symptom chart,” he says. “A dietitian or nutritionist also can make sure you don’t cut out foods that provide necessary vitamins and nutrients.”

Once you’ve identified the problem food (or foods), you are guided on whether to adjust portions, change your eating habits — like when, and how fast, you eat—or switch out the food entirely.

“You don’t always have to give up foods you enjoy, but by addressing your changing digestive system, you can make eating more pleasurable and ensure you maintain a healthy diet,” says Dr. Fasano.

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