Dairy Dilemma

No need to suffer with lactose intolerance

Do you experience cramps, intestinal gas and bloating, or diarrhea after eating dairy products? Those annoying gastrointestinal symptoms could be a clue that you're "lactose intolerant."

The condition is caused by having low levels of lactase, the enzyme that digests the sugar in milk products. An estimated 30 to 50 million Americans are lactose intolerant, including a majority of African-Americans, AsianAmericans, and many Latinos.

Lactose intolerance is not the same as milk protein allergy. Milk allergy symptoms include skin rashes, hives, watery eyes and, in severe cases, anaphylaxis, with swollen throat tissues that impede breathing.

Making a diagnosis

The classic symptoms of lactose intolerance appear 30 minutes to two hours after eating dairy products, and vary in intensity depending on the individual and the amount of food consumed.

Because the symptoms are similar to other gastrointestinal problems (such as irritable bowel syndrome), making a precise diagnosis can be tricky. But you can undergo a simple hydrogen breath test that allows doctors to pinpoint the problem.

"The test measures the amount of hydrogen gas produced by the fermentation of lactose by bacteria in the colon," explains Jaime Aranda-Michel, MD, assistant professor of medicine in the Division of Digestive Diseases at the University of Cincinnati. Part of the hydrogen produced by the fermentation of undigested lactose is absorbed into the blood and exhaled.

The test involves measuring baseline hydrogen after an overnight fast, and again at regular intervals after you're given 50 grams of lactose (equivalent to a quart of milk). You simply breathe into a special plastic collection bag, and hydrogen levels are measured.

Don't dump the dairy

A positive test doesn't automatically mean milk and other dairy products must be eliminated from the diet. Many dairy products contain less lactose, and may provoke fewer symptoms (see chart).

Giving up dairy entirely can lead to low levels of calcium, vitamins A and D, phosphorus and protein, increasing the risk of osteoporosis and hypertension.

Some products contain lactase and help convert lactose into easily digested sugars. You can choose from drops that you add to food, capsules or chewables taken before eating dairy products, and lactose-free milks. These products include Lactaid, Dairy Ease, Dairy Relief, and NutriMil. Among the milk products are Parmalat, Borden Plus, and Lactaid. All are rich in calcium; each eight-ounce glass of Lactaid fat-free milk contains 500 milligrams (mg) of calcium.

Carol Milano

WHAT YOU CAN DO If you have Lactose Intolerance: Make sure you get enough calcium from non-dairy sources. Eat foods containing less lactose. Try products containing lactase that aid dairy digestion. If symptoms persist despite dietary precautions, see your doctor.

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