LACTOSE INTOLERANCE

(Milk Intolerance; Lactase Deficiency)

 Basic information

description

Lactose intolerance is the inability to digest lactose, a sugar found in milk products. It is a common disorder. It usually develops in teens and adults and continues for life. Some infants are born with it. Lactose intolerance (a digestive problem) is different from a milk allergy (which involves the body's immune system).

FREQUENT SIGNS & SYMPTOMS

• Symptoms will vary depending on the amount of lactose each person can tolerate. Symptoms occur about 30 minutes to 2 hours after eating or drinking foods that contain lactose. They may be mild to more severe.
• Rumbling stomach sounds.
• Stomach cramps and diarrhea.
• Gas and bloating.
• Nausea.
• Newborns may have foamy diarrhea, diaper rash, vomiting (sometimes), and slow weight gain.

causes

• Deficiency or absence of the enzyme lactase. Lactase is produced by the small intestine and is needed to digest all milk except mother's milk. Without it, sugars in milk absorb fluid and cause symptoms. Lactase production tends to decrease after childhood as the diet changes and is less dependent on milk.
• Secondary (or acquired) lactose intolerance occurs after an illness, surgery, injury, or along with certain diseases (e.g., Crohn's disease). This intolerance usually resolves on its own, but may be permanent.

risk increases with

• Family history of lactase enzyme deficiency.
• Genetic factors. It is more common in Blacks, Native Americans, Asians, Hispanics, and Ashkenazi Jews.

PREVENTIVE MEASURES

Cannot be prevented at present.

expected outcomes

There is no cure for this disorder, but it does not cause a threat to good health. Symptoms can be controlled with diet changes. Symptoms may worsen at times for unknown reasons.

possible complications

Calcium deficiency and weak bones (rare).

 diagnosis & treatment

general measures

• Your health care provider may do a physical exam. A trial period of no dairy products may be advised to see if symptoms stop. Medical tests may include blood studies, a hydrogen breath test, or lactose absorption test.
• Treatment involves diet changes. They can vary for each person depending on their symptoms. Many people with lactose intolerance can still drink or eat some amount of milk products each day. Using lactase enzymes is also an option.
• To learn more: National Institute of Diabetes and Digestive and Kidney Disorders, 2 Information Way, Bethesda, MD 20892; (800) 891-5389; website: www.digestive.niddk.nih.gov.

medications

• The enzyme lactase is available without a prescription. It can be taken as a tablet or as a liquid that is added to milk and milk products. It acts in much the same way as the naturally occurring enzyme does.
• Some prescription and nonprescription drugs contain lactose as an ingredient. These include some birth-control pills and antacids. They may affect people who have severe lactose intolerance.

activity

No limits.

diet

• Reduce or restrict milk and milk products, such as cheese and ice cream. Lactose-free milk is available.
• Yogurt and fermented products such as hard cheese are often tolerated better than milk.
• Read food labels with care. Avoid products that contain milk, lactose, milk sugar, whey, curds, milk by-products, dry milk solids, and nonfat dry milk powder.
• Infants: if the condition is present at birth, an infant formula that contains little or no lactose, such as a soybean-based formula, will be recommended. If the lactose intolerance is short-term and caused by illness, a substitute formula is needed for a short time. Cow's milk can be introduced again later.
• Ask your health care provider about calcium supplementation.

 notify our office if

• You or your child has lactose intolerance symptoms.
• A milk-free diet doesn't relieve symptoms.
• Infant fails to gain weight or refuses food or formula.

Special Notes: