Lactose Intolerance

Lactose is a sugar found in milk and milk products. Lactose intolerance is the inability or insufficient ability to digest lactose. It is caused by a deficiency of the enzyme lactase, which is produced by the small intestine.

Most people with lactose intolerance can tolerate some amount of lactose in their diet. People sometimes confuse lactose intolerance with cow milk allergy. Milk allergy most commonly appears in the first year of life, while lactose intolerance occurs more often in adulthood.

Primary lactase deficiency develops over time and begins after about age 2 when the body begins to produce less lactase. Most children who have lactase deficiency do not experience symptoms of lactose intolerance until late adolescence or adulthood.

Secondary lactase deficiency results from injury to the small intestine that occurs with severe diarrheal illness, celiac disease, Crohn's disease, or chemotherapy. This type of lactase deficiency can occur at any age but is more common in infancy.

Patients with lactose intolerance may feel uncomfortable 30 minutes to 2 hours after consuming milk and milk products. Symptoms range from mild to severe based on the amount of lactose consumed and the amount a person can tolerate and include abdominal pain, abdominal bloating, gas, diarrhea and nausea.

How is lactose intolerance diagnosed?

Hydrogen Breath Test. The person drinks a lactose-loaded beverage. The breath is then analyzed at regular intervals to measure the amount of hydrogen. Normally, very little hydrogen is detectable in the breath. Undigested lactose produces high levels of hydrogen. Smoking and some foods and medications may affect the accuracy of the results.

What to do?

Although the body's ability to produce lactase cannot be changed, the symptoms of lactose intolerance can be managed with dietary changes. Most people with lactose intolerance can tolerate some amount of lactose in their diet. Gradually introducing small amounts of milk or milk products may help some people adapt to them with fewer symptoms. Often, people can better tolerate milk or milk products by taking them with meals.

Lactose-free and lactose-reduced milk and milk products, available at most supermarkets, are identical to regular milk except that the lactase enzyme has been added. Lactose-free milk remains fresh for about the same length of time or longer than regular milk if it is ultra-pasteurized. Lactose-free milk may have a slightly sweeter taste than regular milk. FOODS THAT CONTAIN LACTOSE

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