| Lactose Intolerance
Learn how the new prebiotic soluble fibers benefit bowel health and many GI disorders
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.
Learn how the new prebiotic soluble fibers benefit bowel health and many GI disorders
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.
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Chek Med Systems®, Inc., All Rights Reserved.
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