Health Care and Lactose Intolerance

Many Americans suffer from an intolerance to dairy products, and some even are so allergic that encounters with milk, ice cream, cheese, or any dairy item can cause anaphylaxis and possible death. Lactose interolerence is a medical condition that has health care implications and should be addressed by your doctor or a medical practitioner. Most people suffering from this malady see it as an inconvenience and are able to deal with it by watching their diet. Serious conditions require more vigilant care and dietary restrictions.

 

Lactose intolerance is the inability or insufficient ability to digest lactose, a sugar found in milk and milk products. Lactose intolerance is caused by a deficiency of the enzyme lactase, which is produced by the cells lining the small intestine. Lactase breaks down lactose into two simpler forms of sugar called glucose and galactose, which are then absorbed into the bloodstream, according to the National Digestive Diseases Information Clearinghouse (NDDIC). Not all people with lactase deficiency have digestive symptoms, but those who do may have lactose intolerance. 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 is a reaction by the body’s immune system to one or more milk proteins and can be life threatening when just a small amount of milk or milk product is consumed. Milk allergy most commonly appears in the first year of life, while lactose intolerance occurs more often in adulthood.
After eating foods with lactose in them, you may feel sick to your stomach, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIH). Some illnesses can cause these same symptoms. If you have these symptoms after you eat or drink milk and milk products, see your doctor. You may also have:

--Gas.
--Diarrhea.
--Swelling in your stomach.

Your doctor may do a blood, breath or stool test to find out if your problems are due to lactose intolerance.
Lactose intolerance is not serious, according to the NIH. Eating less food with lactose, or using pills or drops to help you digest lactose usually helps. You may need to take a calcium supplement if you don't get enough of it from your diet, since milk and foods made with milk are the most common source of calcium for most people.

Some people become lactose intolerant as children, according to the NDDIC. In others, the problem starts when they are teenagers or adults. Lactose intolerance is rare in babies. Premature babies may be lactose intolerant for a short time after they are born. Lactose intolerance is common in certain areas of the world. Certain groups are more likely to be lactose intolerant:
•Asian Americans.
•African Americans.
•American Indians.
•Hispanics/Latinos.
•People with southern European heritage.

People of northern European descent are least likely to be lactose intolerant, according to the NDDIC. If your small intestine has been damaged, it may produce less lactase enzyme, causing you to become lactose intolerant. The small intestine can be hurt by the following:
•Diseases such as celiac disease or Crohn’s disease.
•Infections.
•Surgery.
•Injuries.

According to the National Institutes for Health (NIH), 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. The amount of change needed in the diet depends on how much lactose a person can consume without symptoms. For example, one person may have severe symptoms after drinking a small glass of milk, while another can drink a large glass without symptoms. Others can easily consume yogurt and hard cheeses such as cheddar and Swiss but not milk or other milk products.

The Dietary Guidelines for Americans 2005 recommend that people with lactose intolerance choose milk products with lower levels of lactose than regular milk, such as yogurt and hard cheese. 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. Soy milk and other products may be recommended by a health professional. People who still experience symptoms after dietary changes can take over-the-counter lactase enzyme drops or tablets. Taking the tablets or a few drops of the liquid enzyme when consuming milk or milk products may make these foods more tolerable for people with lactose intolerance. Parents and caregivers of a child with lactose intolerance should follow the nutrition plan recommended by the child’s doctor or dietitian.

According to the NIH, you can change your diet to manage your symptoms. Most people with lactose intolerance do not have to give up milk or milk products. You may be able to tolerate milk and milk products if you observe the following steps:

•Drink small amounts of milk—4 ounces or less—at a time.
•Drink small amounts of milk with meals.
•Gradually add small amounts of milk and milk products to your diet and see how you feel.
•Eat milk products that are easier for people with lactose intolerance to digest, such as yogurt and hard cheeses like cheddar and Swiss.

Rarely, people with lactose intolerance are bothered by small amounts of lactose, according to the NIH; and some boxed, canned, frozen, packaged, and prepared foods contain small amounts of lactose. These foods include the following:

•Bread and other baked goods.
•Waffles, pancakes, biscuits, cookies, and mixes to make them.
•Prepared or frozen breakfast foods such as doughnuts, frozen waffles and pancakes, toaster pastries, and sweet rolls.
•Boxed breakfast cereals.
•Instant potatoes, soups, and breakfast drinks.
•Potato chips, corn chips, and other packaged snacks.
•Prepared meats, such as bacon, sausage, hot dogs, and lunch meats.
•Margarine.
•Salad dressings.
•Liquid and powdered milk-based meal replacements.
•protein powders and bars.
•Certain candies.
•Non-dairy liquid and powdered coffee creamers.
•Non-dairy whipped toppings.

According to the Mayo Clinic, your doctor may suspect lactose intolerance based on your symptoms and your response to reducing the amount of dairy foods in your diet. Your doctor can confirm the diagnosis by conducting one or more of the following tests:


■Lactose tolerance test. The lactose tolerance test gauges your body's reaction to a liquid that contains high levels of lactose. Two hours after drinking the liquid, you'll undergo blood tests to measure the amount of glucose in your bloodstream. If your glucose level doesn't rise, it means your body isn't properly digesting and absorbing the lactose-filled drink.

■Hydrogen breath test. This test also requires you to drink a liquid that contains high levels of lactose. Then your doctor measures the amount of hydrogen in your breath at regular intervals. Normally, very little hydrogen is detectable. However, if your body doesn't digest the lactose, it reaches your colon and ferments, causing hydrogen and other gases to be released, absorbed by your intestines and eventually exhaled. Large amounts of exhaled hydrogen measured during a breath test indicate that you aren't fully digesting and absorbing lactose.

■Stool acidity test. For infants and children who can't undergo other tests, a stool acidity test may be used. Undigested lactose ferments in the colon, creating lactic acid and other acids that can be detected in a stool sample. The lactose tolerance test and the hydrogen breath test may be dangerous for infants and children who can't tolerate high levels of lactose required for those tests.

Much more detailed information about home remedies and foods, treatments, and medications can be found at the Mayo Clinic site for this health care issue: http://www.mayoclinic.com/health/lactose-intolerance/DS00530/DSECTION=lifestyle-and-home-remedies . Additional websites will have a host of information about lactose intolerance and how to deal with it. So, when you think this may be an issue with you, and you appear to suffer the symptoms, it would be in your very best interest to visit your doctor and get tested for the possible outcome. People with this malady live very happy, healthy lives and accordingly adjust their lifestyles.
 
Until next time.