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MANY PEOPLE suffer from severe cramps, gas and diarrhea whenever they ingest dairy products such as milk, cheese and ice cream.
These people suffer from lactose intolerance, a relatively common inability to digest lactose, the predominant sugar in milk. People with lactose intolerance do not produce enough of the enzyme lactase, which is required to break down the milk sugar in the intestines. Without sufficient lactase, the milk sugar passes through the stomach undigested and reaches the large intestine where it ferments, causing some people to experience abdominal pain, bloating, gas and diarrhea. (Contrary to popular belief, lactose intolerance is not really an allergic reaction to milk, but rather is because of the inability of the body to break down certain ingredients within milk.)
Symptoms of lactose intolerance may develop from 30 minutes up to several hours after consuming foods or drinks that contain lactose.
Lactose intolerance most often affects Asians, blacks, Native Americans and other groups of people who traditionally consume few milk products. About 20 percent of Caucasians experience symptoms related to this condition. Since the production of lactase decreases in most people after infancy, a large portion of the general population may suffer from this enzyme deficiency as they grow older or if they suffer from certain intestinal disorders.
The symptoms of lactose intolerance vary depending on the amount of lactose consumed and the amount of lactase that is produced. Therefore, a person may suffer mild symptoms of lactose intolerance for years without the diagnosis being made. If you have frequent episodes of nausea, cramps, diarrhea, floating and foul-smelling stools, bloating or intestinal gas, you may be lactose intolerant. Similarly, this condition may be the cause of malnutrition, weight loss and slow growth in children.
The simplest and most common way to diagnose lactose intolerance is by exclusion. Avoiding dairy products for several weeks should eliminate the symptoms. If symptoms recur when dairy products are reintroduced to the diet, the diagnosis of lactose intolerance is highly likely.
Some people with lactose intolerance can consume milk products in different forms. Try fermented milk products such as yogurt, buttermilk or kefir, since bacterial cultures in these products naturally break down some of the lactose. For those who love ice cream, there are now some non-dairy products that taste remarkably similar to the real thing. Visit your health food store and see what options are available. Other possible solutions are to take an over-the-counter medication containing the enzyme lactase before consuming milk products, or to drink special milk without lactose (such as Lactaid), which is available in the dairy case of many supermarkets.
When shopping, be sure to carefully read labels, which indicate how much, if any, lactose is present in anything you want to buy. When eating out in a restaurant, it is important to ask about the ingredients in various dishes, especially since many restaurants add butter (rich in lactose) to everything they serve.
Because dairy products are an important source of calcium, eliminating them from the diet can cause calcium deficiency. Calcium supplements are readily available. Incorporate calcium-rich foods in your diet, such as calcium-fortified orange juice, tofu, almonds and green vegetables.
Virgil Williams and Ron Eisenberg are staff physicians at Highland General Hospital in Oakland. Their column runs Mondays in Bay Area Living. You can write to them at P.O. Box 10367, Pleasanton, CA 94588 or send e-mails in care of firstname.lastname@example.org. Questions cannot be answered individually; however, some will be discussed in future columns.