Dr. M.J. Bazos,
Patient Handout
LACTOSE
INTOLERANCE
About Your
Diagnosis
If you have difficulty digesting cow’s
milk, you have lactose intolerance. Lactose is the main sugar in cow’s
milk. This inability to digest lactose is caused by a shortage of the enzyme
lactase. Lactase is normally made by the cells that line the small intestine. If
these cells are damaged by injury or certain diseases, the production of lactase
can be decreased or absent. In rare cases a child is born with the condition and
is unable to produce lactase. The lactase breaks down milk sugar into simpler
forms that can then be absorbed into the bloodstream. When there is not enough
lactase to digest the amount of lactose consumed, you may have symptoms. Lactose
intolerance is a common condition. Between 30 and 50 million Americans have the
condition. It occurs more commonly as you age. It also occurs more commonly in
certain racial and ethnic groups. As many as 90% of Asian Americans and 75% of
African Americans and Native Americans are lactose intolerant. This condition is
least common in individuals of Northern European descent. The condition is
detected by tests used to measure the absorption of lactose from the digestive
tract. These tests are the lactose tolerance test, the hydrogen breath test, and
the stool acidity test. The stool acidity test should be used in children. All
of these tests can be done as an outpatient. Rarely a small tissue sample
(biopsy) may need to be takenfrom the
small bowel. This condition is not curable but the symptoms are controllable
with diet modification and
treatment.Living With Your
DiagnosisCommon symptoms of lactose
intolerance usually begin 30 minutes to 2 hours after eating or drinking foods
containing lactose. Symptoms include nausea, abdominal cramps, bloating, gas,
and diarrhea. In children the symptoms are slightly different. Children tend to
have foamy diarrhea and diaper rash and sometimes vomiting. Children also have
slowed growth and
development.TreatmentLactose
intolerance is easy to treat. Infants and young children with lactose
intolerance should not have foods containing lactose. Older children and adults
generally do not have to avoid lactose products completely but should identify
the amounts they can tolerate. If an older child or adult can only tolerate
small amounts of lactose, lactase enzymes in drop and chewable forms are
available over-thecounter. The drops can be put in milk before drinking. The
chewable tablets are used to help individuals digest solid foods that contain
lactose. The
DOs• Read food labels carefully
to avoid foods that may contain
lactose.• Talk to your physician or
a dietitian about a proper balanced
diet.• Ensure adequate calcium
intake through either diet or supplementation. Foods that are high in calcium
include broccoli, kale, greens, oysters, and fish with soft bones (salmon and
sardines).• Yogurt and hard cheeses
may be better tolerated and are high in
calcium.• Ensure adequate vitamin D
intake to help with calcium metabolism. Exposure to sunlight will help with
this. Eggs and liver are also good sources of vitamin
D.• If you have a family history of
lactose intolerance, consider breast-feeding your
baby.• Infants with lactose
intolerance should be given a soy-based
formula.The
DON’Ts• Avoid foods that
may contain hidden lactose. These include bread and other baked goods, processed
breakfast cereals, instant potatoes, soups, breakfast drinks, margarine, lunch
meats (other than kosher), salad dressings, candies, and mixes for pancakes,
biscuits, and cookies.• Avoid
prescription and over-the-counter medications that contain lactose as a base if
you have severe lactose intolerance. Ask your pharmacist about specific
medications.When to Call Your
Doctor• If you or your child has
symptoms of lactose intolerance.• If
a milk-free diet does not improve
symptoms.• If your child fails to
gain weight.• If your child refuses
food or
formula.Websites:www.niddk.nih.govnddic@aerie.com