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Got Milk? Got Indegestion? STORY BY

Wendy Cederberg

After dipping into your bovine-friendly refrigerator stocked with your favorite dairy products, does your stomach raise a ruckus? While this may mean you are suffering from lactose intolerance, don't have a cow over it.

"Lactose intolerance, or LI, is fairly easy to treat and manage, meaning you can usually control symptoms through diet," explains Dr. Marilyn Edwards, associate professor in the Department of Internal Medicine and a nutrition specialist at the University of Texas Medical School at Houston.

If you can't drink milk or eat dairy products without getting an upset stomach, you are not alone. Approximately 30-50 million Americans are lactose intolerant, meaning they have a deficiency in lactase, the enzyme required to digest and absorb milk sugar, or lactose.

What is Lactose Intolerance?

Lactose Intolerance is the inability to digest significant amounts of lactose, the predominant sugar found in milk and other dairy products. If you do not manufacture enough of the enzyme lactase to digest the lactose consumed, the results may be, shall we say, uncomfortable.

Symptoms

Did you ever feel like you have a "rumbly in my tummy" as Winnie the Pooh says?

Symptoms of LI include abdominal discomfort, such as severe bloating, gas, cramps and diarrhea. Symptoms vary from mild to severe, depending on the amount of lactose ingested, and may occur from 30 minutes to a few hours after eating.

Folks will differ in the amount and type of foods they can tolerate. One person may have symptoms after a small glass of milk and another individual may be fine after one glass, but reach misery after two glasses.

Who Has LI?

"LI has been around for centuries," Edwards says, "and for most people, this condition develops naturally over time."

The highest frequency of LI occurs in the populations of African descent, native Mexicans, Hispanics, Asians, Jews and Arabs. The prevalence among North American Caucasians is very low, approximately 6-12 percent.

How Do You Know For Sure?

The most common diagnostic tests are the lactose tolerance test, hydrogen breath test and stool acidity test, done on an outpatient basis. The lactose tolerance and hydrogen breath tests are not administered to infants and children, but if necessary, the stool acidity test (measuring the amount of acid in the stool) may be recommended.

Here's a simple test to see if you have LI: stop drinking milk or eating any dairy products for at least two weeks. If your symptoms improve after the two-week period, you can ease back into dairy foods. Drink a little milk or eat some cheese - then see if symptoms occur.

What Can I Eat and Drink?

Your diet is a good way to learn how much lactose you can handle.

It's okay to:

"Surprisingly, yogurt is sometimes better tolerated than milk," Edwards adds. "The bacterial cultures in yogurt have some of the lactase enzyme necessary for good digestion. However, frozen yogurt has little or no lactase activity." Beware of processed cheese or cheese foods that have nonfat dry milk solids.

Hidden Lactose

Sometimes lactose doesn't wear a cow bell to let you know it's coming. People who are highly sensitive to lactose need to investigate the most minute amounts in certain prepared foods.

Here are a few of the sneakier ways lactose can creep into your diet:

Even some foods labeled as nondairy-coffee creamers, whipped cream-may have some ingredients that are derived from milk products.

Savvy sufferers have learned to read labels carefully. "See if dry milk solids or other lactose-containing components are included," Dr. Edwards recommends. "Some medications contain lactose fillers which can potentially trigger symptoms in sensitive individuals."

Calcium-Challenged?

Because milk and other dairy products are a primary source of calcium, you may be concerned about not getting enough. Nondairy foods that are calcium-rich include green vegetables, such as broccoli and kale, and seafood, such as salmon and sardines.

Edwards suggests that it may be helpful to consult your physician or a dietician to discuss appropriate nutrition.

An Option to Dairy Delight

Lactose-hydrolyzed milk, Lact-Aid, Lactrase, or Dairy-Ease can be used in place of regular milk. There is a non-prescriptive lactase enzyme tablet or liquid that helps individuals digest foods with lactose. The tablet is taken with your first bite of food, and for many individuals, this provides an effective tool to ease LI symptoms.

Just remember that the next time you get a "rumbly in your tumbly" you may have to consider adjusting your cow-friendly lifestyle.

Last Updated: 2-26-2004

 

The University of Texas Health Science Center at Houston (UTHealth), the most comprehensive academic health center in The UT System and the U.S. Gulf Coast region, is home to schools of biomedical informatics, biomedical sciences, dentistry, medicine, nursing and public health. UTHealth educates more healthcare professionals than any health-related institution in the State of Texas and features the nation’s seventh-largest medical school. It also includes a psychiatric hospital and a growing network of clinics throughout the region. The university’s primary teaching hospitals include Memorial Hermann-Texas Medical Center, Children’s Memorial Hermann Hospital and Lyndon B. Johnson General Hospital. Founded in 1972, UTHealth’s 10,000-plus faculty, staff, students and residents are committed to delivering innovative solutions that create the best hope for a healthier future.