Patterns and Management of Food Intolerance in Albania: A Cross-Sectional Study of Symptoms and Diagnostic Gaps

Food intolerance is increasingly recognized as a public health concern across Europe, yet evidence from Southeastern countries, including Albania, remains limited. This study aimed to investigate the self-reported prevalence, symptom patterns, and management of food intolerance in Albania, while addressing gaps in diagnosis and healthcare access. A cross-sectional survey of 200 participants conducted in Albania in 2025 was combined with a focused narrative review of European literature. Data were collected using a structured questionnaire assessing gastrointestinal and systemic symptoms, dietary triggers, diagnostic history, and self-management practices. Statistical analyses included descriptive statistics, one-way ANOVA, binary logistic regression, and Principal Component Analysis (PCA). Gastrointestinal symptoms were the most prevalent, particularly bloating and abdominal discomfort (45.7%), followed by bowel irregularities (23.4%), fatigue (19.1%), and headache (11.7%). Despite the high prevalence of symptoms, only ~18% of participants reported a formal diagnosis, indicating a substantial gap between symptom experience and clinical evaluation. Logistic regression identified stress level and supplement use as significant predictors of diagnosis, while PCA revealed two primary symptom domains: gastrointestinal and systemic. Overall, the findings demonstrate that food intolerance in Albania is influenced by both individual and system-level factors, particularly limited access to diagnostic pathways. This study provides new evidence from a previously under-researched region and contributes to the understanding of food intolerance by integrating symptom patterns, behavioral responses, and healthcare access within a unified framework.