Do You Have Trouble with Milk? Find Out About Lactose Intolerance

Lactose intolerance is the inability to digest large amounts of lactose, the predominant sugar in milk. This is due to a shortage of the enzyme lactase, which is normally produced by the cells that line the small intestine.

Lactase breaks down milk sugar into simpler forms that can then be absorbed into the bloodstream. Depending on the amount of lactose a person can tolerate, anywhere from 30 minutes to two hours after eating food containing lactose symptoms will begin to appear.

Common symptoms include nausea, cramps, bloating, gas, and diarrhea. And the severity of symptoms varies depending on the amount of lactase each person has, and not all persons deficient in lactase will have symptoms.

For most people, lactose intolerance develops slowly over time. After about the age of 2 years, the body begins to produce less lactase. However, many people may not experience symptoms until they are much older. Lactose intolerance is fairly common.

As many as 75 percent of all African-Americans and Native Americans and 90 percent of Asian-Americans are lactose intolerant. The condition is least common among persons of northern European descent.

Your doctor can tell you if your problems are caused by lactose intolerance. Simply eliminating lactose from your diet and the symptoms resolving may be sufficient for your doctor to make a diagnosis.

If the picture is still not clear, there are tests available to measure how well you digest lactose. These tests are the lactose tolerance test and the hydrogen breath test. These tests are performed on an outpatient basis at a doctor's office.

The lactose tolerance test begins with you drinking a sweet drink with lactose in it. The doctor will then test your blood for signs that you did or did not digest the lactose. This test is available for children and adults.

The hydrogen breath test measures the amount of hydrogen in the breath. In the test, the patient drinks a lactose-loaded beverage, and the breath is analyzed at regular intervals for hydrogen gas.

Raised levels of hydrogen in the breath indicate improper digestion of lactose. Certain foods, medications, and cigarettes can affect the test's accuracy and should be avoided before taking the test.

If a baby or young child is experiencing symptoms of lactose intolerance, many pediatricians simply recommend changing from cow's milk to soy formula and waiting for symptoms to abate.

Controlling the symptoms of lactose intolerance depends on each person's learning through trial and error how much lactose in the diet one can handle. For example, one person may suffer symptoms after drinking a small glass of milk, while another can drink one glass but not two.

Others may be able to manage ice cream and aged cheeses, such as cheddar and Swiss but not other dairy products. For those who react to very small amounts of lactose or have trouble limiting their intake of foods that contain lactose, lactase enzymes are available without a prescription.

One form is a liquid for use with milk. A more recent development is a chewable lactase enzyme tablet that helps people digest solid foods that contain lactose. These tablets are taken just before a meal or snack.

Lactose-reduced milk and other products are available at many supermarkets. The milk contains all of the nutrients found in regular milk and remains fresh for about the same length of time or longer if it is super-pasteurized.

Although milk and foods made from milk are the main sources, lactose is found in many prepared foods. You will have to learn to read labels with care, looking not only for milk and lactose among the contents but also for such words as whey, curds, milk by-products, dry milk solids, and nonfat dry milk powder.

Some products labeled nondairy, such as powdered coffee creamer and whipped toppings, may also include ingredients that are derived from milk and therefore contain lactose. If any of these are listed on a label, the item contains lactose.

Lactose is used as a base in a fair number of prescription and over-the-counter medicines. Many types of birth control pills, for example, contain lactose, as do some tablets for stomach acid and gas. However, these products typically affect only people with severe lactose intolerance.

A concern for those who are lactose intolerant is getting enough calcium in a diet. Milk and other dairy products are a major source of calcium in the diet. Calcium is essential for the growth, strength and repair of bones throughout life. In the middle and later years, a shortage of calcium may lead to thin, fragile bones that break easily (a condition called osteoporosis).

It is possible to get the required amount of calcium even if the diet does not contain dairy products. Many nondairy foods are high in calcium. Green vegetables, such as broccoli and kale, and fish with soft, edible bones, such as salmon and sardines, are excellent sources of calcium. Factors other than calcium and lactose content should be kept in mind when planning a diet. Some vegetables that are high in calcium (Swiss chard, spinach, and rhubarb, for instance) can not be used by the body for their calcium content.

They contain substances called oxalates, which stop calcium absorption. Also calcium is absorbed and used only when there is enough vitamin D in the body. Sunlight helps the body naturally absorb or synthesize vitamin D, and with enough exposure to the sun, food sources may not be necessary. Some sources of vitamin D in the diet include eggs and liver. Consultation with a doctor or dietitian may be helpful in deciding whether any dietary supplements are needed.

Yogurt with active cultures is a good source of calcium for many people with lactose intolerance, even though it is fairly high in lactose. The bacterial cultures used in making yogurt produce some of the lactase enzyme required for proper digestion.

How much calcium a person needs to maintain good health varies by age group. Also, pregnant and nursing women under 19 need 1,300 mg daily, while pregnant and nursing women over 19 need 1,000 mg.

So by limiting dairy products or by using lactose free products you can overcome the uncomfortable symptoms associated with lactose intolerance and at the same time maintain your intake of the vital nutrients contained in dairy products. Its kind of like having your cake and eating it too.

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