Lactose Intolerance

Lactose Intolerance

What is lactose intolerance?

Lactose intolerance is difficulty digesting dairy products.  Lactase is the enzyme normally found within the small bowel that is responsible for digesting lactose.  Lactose is found in dairy and milk products.  When the intestine does not contain lactase, or the lactase does not work properly, milk and dairy intolerance occurs.

What are the symptoms of lactose intolerance?

When lactose does not get properly digested, it reaches the colon and gets broken apart by bacteria.  This process is called bacterial fermentation, and its by-product is gas production.  Gas can lead to many symptoms, including nausea, bloating, belching, abdominal cramps, diarrhea and rectal gas.

How do I know if I have lactose intolerance?

Your medical history, or story, often gives away the answer.  Many people recognize that dairy and milk products produce gastrointestinal symptoms.  Patients may already be avoiding dairy products due to these symptoms.  If you have not tried eliminating dairy products, this is a very easy place to start.  Discontinue all dairy products for two weeks and see if your gastrointestinal symptoms improve.  Then add a large glass of milk and see if new symptoms arise.

More scientific ways exist to prove lactose intolerance.  Hydrogen is produced when lactose is fermented abnormally.  A hydrogen breath test involves measuring the amount of hydrogen expressed after consumption of milk or other dairy products.

What is the treatment?

For patients with mild symptoms, avoidance of large amounts of milk or dairy can be adequate to control symptoms.  For more serious disease, lactose avoidance is best.  Labels must be checked carefully.  Lactose alternatives, such as soy, are becoming more commonly available.  Milk is now available with lactase added.  Lactase tablets are over-the-counter, and can be ingested prior to taking milk products.

Are there any problems with avoiding milk products?

Milk and dairy products are a major source of calcium.  Although many other sources of calcium exist, people who strictly avoid dairy products must be conscious to consume adequate amounts of calcium.  Most people need 1000mg of calcium daily.  Nursing mothers should consume 1200mg daily, and postmenopausal women 1500mg daily.  Discuss with your physician the best way to ingest or supplement calcium.

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