A food holiday is the most important initial experiment since the sick patient stops eating the foods that are making him or her ill, the illness subsides and symptoms clear. 10 days became the standard food holiday because most symptoms improved within 10 days, although for the sickest patients, up to 20 days was sometimes required before the symptoms cleared. Some times, the improvement was obvious in a few days, but we recognized that most patients felt worse for a few days before they started to improve. Patients with in-between disease have some of the symptoms and signs that suggest the diagnosis of specific disease but not everything fits together. Most chronic diseases take many years to evolve so that many in-between patients are on their way to the final disease product.
Patients often discount or fail to report long-term, chronic or recurrent symptoms.
They often believe they will be considered hypochondriacs if they tell it all. Symptoms of a mild ADS are often intermittent and ambiguous. The Intensity of Sick All Over Syndrome Patients with non-specific hypersensitivity illness of moderate intensity tend to become disabled without objective signs of their disease. Often the laboratory investigations reveal nothing, even when symptoms are moderately severe. These patients are most often constrained by three symptom patterns - fatigue, cognitive dysfunction and chronic pain.