GastroEast Physicians, Louisville, KY

Lactose Intolerance cow

Lactose intolerance is a common condition, which affects most people as they get older. A large percent of the US population will have some form of lactose intolerance after age 50. Certain ethnic backgrounds such as African Americans and Asian Americans have a higher incidence of lactose intolerance.

What is Lactose?
The lining of the small intestine is used for the breakdown of food products and for the absorption of these food products into the bloodstream. Sugars are broken down and absorbed here. Specifically, in a normal person, the enzyme lactase is used to breakdown many sugars including lactose, which is product of this sugar breakdown.

Lactose in turn is broken down to glucose and galactose. These simple sugars are the end products of sugar digestion.

Causes and Symptoms
The deficiency of the enzyme lactase causes this sugar to avoid absorption; and symptoms such as bloating, diarrhea, nausea, cramping, and excess gas can occur. These symptoms begin approximately one hour after consuming lactose-containing food such as milk, cheese, and ice cream.

Treatment
The treatment for suspected lactose intolerance is to avoid all dairy products and check for resolution of symptoms. Rarely, if the diagnosis is in doubt a lactose-breath test can be ordered by a physician.

Treatment of lactose intolerance requires dietary modification. Some people with lactose intolerance must avoid all dairy products to avoid package symptoms. Others may be able to eat ice cream or cheese pizza, but must avoid milk to avoid symptoms. Therefore, dietary modification needs to be individualized for each patient on a trial-and-error basis.

For patients with severe symptoms who cannot avoid dairy products completely, a lactase supplement can be taken to aid in the breakdown and absorption of lactose. These lactase enzymes can be purchased over the counter and a visit to a physician is not necessary.

Calcium in the diet -- not just found in milk products
Many people believe that dairy products are an important source of calcium and must be an integral part of all adult diets. It is true that calcium is necessary in all individuals to help prevent osteoporosis or thinning of the bones, but calcium can be found in many non-dairy foods such as fish and vegetables. Calcium can also be supplemented in pill form and can be purchased over the counter. If you avoid all dairy products, it will be important to discuss with a physician the amount of supplemental calcium that will be needed in your diet.

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