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Lactose Intolerance
Lactose
intolerance develops when the body has difficulty digesting whole and
skim milk and other dairy products. Lactose is a milk sugar and like
most sugars, it is broken down by enzymes in the intestinal tract so
it can be absorbed as an energy source. The enzyme that breaks down
lactose is called lactase. When the intestine does not contain
lactase, then lactose intolerance can occur. It is a troublesome and
annoying problem, but it is never a serious one.
Who Has Lactose Intolerance?
As commonly expected, infants and small children have the enzyme
lactase so they can digest mothers' milk. However, during childhood,
lactase begins to disappear in many people. Some ethnic groups are
more likely to develop lactose intolerance. By adolescence, it is
gone in about 75% of African-Americans, Jews, Native Americans,
Hispanic persons, and in 90% of Asians. So the condition is very common.
What Are The Symptoms?
When undigested lactose reaches the colon (large intestine), it is
broken apart by bacteria. Lactic acid and other acidic chemicals
result. It is these products that create the symptoms of lactose
intolerance. These symptoms include nausea, abdominal cramps and
rumbling, bloating, rectal gas (flatus), and diarrhea. They usually
occur 30 minutes to two hours after ingesting lactose-containing
foods. The severity of symptoms usually depends on the amount of
lactose ingested and how much of the enzyme, lactase, remains in the
intestinal tract.
The Diagnosis
First, the physician reviews the patient's medical history. Sometimes
that is enough to determine the problem. However, to make a
definitive diagnosis, one of several tests may be needed:
Lactose Tolerance Test - A test dose of lactose is
ingested and blood sugar determinations are made over several
hours. If lactase is present to break down the lactose load, then
the blood sugar level rises. If no lactase is present, the blood
sugar level does not change.
Hydrogen Breath Test - When lactose is broken down by
the colon's bacteria, hydrogen is released, which then passes out
through the lungs. The amount of hydrogen released after a lactose
meal can indicate a problem.
Stool Acidity Test - When lactose breaks down to lactic
and other acids in the colon, the resulting acidity can be
detected by a simple measurement of stool acidity.
The Home Do-It-Yourself Test - Since lactose intolerance
is not a serious disorder, some people may want to test themselves
at home. First, avoid milk and lactose-containing foods for
several days. Then on a free morning, such as a Saturday, drink
two large glasses of skim or low-fat milk (14-16 oz). If symptoms
develop within four hours, the diagnosis of lactose intolerance is
fairly certain.
Treatment
Therapy depends on whether a patient is willing to tolerate the
symptoms. If the symptoms are mild, then avoiding large amounts of
milk and milk products may be enough. For those who are very
sensitive to small amounts of lactose, there are two options. First,
all foods should be carefully checked for lactose. Grocery items such
as bread, baked goods, cereals, instant potatoes, soups, margarine,
lunchmeat, salad dressings, pancakes, biscuits, cookies, and candy
can contain hidden lactose. Even prescription and over-the-counter
drugs may contain lactose. The patient must become a label reader
looking for and avoiding "milk" and "lactose".
The second option is buying milk to which lactase, the enzyme, has
been added. Lactase drops or tablets are also available which can be
placed in milk. A pharmacist or food store manager can provide
advice. There are over-the-counter lactase tablets that can be taken
with meals to replace the enzyme the body no longer has. Finally, a
variety of lactose-free products are now available in the specialty
section of food stores.
Calcium and Lactose
Milk is a major source of calcium and calcium is necessary for good
health and strong bones. Most people need 1000 mg of calcium a day,
except for pregnant and nursing females (1200 mg per day) and
post-menopausal females (1500 mg per day). The following list from
the National Institutes of Health provides some information on the
calcium and lactose contents of food.
For the lactose-intolerant individual, ingesting enough calcium
may be difficult. Calcium supplements, such as calcium carbonate, are
often recommended. The decision to take calcium supplements should be
discussed with the physician.
Related Diets
Lactose
Free
This material does not cover all information and is
not intended as a subsitute for professional care. Please consult
with your physician on any matters regarding your health.
©
Copyright
Chek Med Systems®, Inc., All Rights Reserved.
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