Lactose Intolerance

I had a 30 year old female present with complaints of intermittent abdominal cramping for months and diarrhea (non-bloody). She denied any vomiting, fever, chills, or urinary complaints. She attempted a food diary but found no direct correlation. Her medical and family history were unremarkable. Her medications included a birth control pill and over the counter Imodium and Tums (which slightly helped). The patient was told in the past she had irritable bowel syndrome. Diagnostic tests were performed and revealed results consistent with lactose intolerance.

Lactose intolerance is a condition where the body does not have enough lactase (an enzyme) to break down lactose (type of sugar found in dairy products) into glucose and galactose. Symptoms occur 30 minutes to two hours after eating or drinking milk or milk products. Severity is usually based on the amount of lactose consumed. Symptoms include:

1. Abdominal bloating and cramping
2. Diarrhea
3. Gas
4. Nausea
5. Foul smelling stools
6. Weight loss

Here is a short list of foods with lactose:

1. Dairy and dairy products
2. Bread and baked goods
3. Processed breakfast cereals and foods (doughnuts, waffles, pancakes, etc...)
4. Instant potatoes
5. Instant soups
6. Salad dressings
7. Margarine
8. Coffee creamers
9. Processed meats (bacon, ham, hot dogs, etc...)
10. Candy
11. Protein supplements and bars
12. Pizza
13. Mosts foods that are creamed, buttered, or breaded

Diagnosis is usually based on history but there are diagnostic tests (Hydrogen breath test and Lactose tolerance test).

Treatment includes:

1. Dietary modification (Good bye pizza)
2. Calcium supplementation (adults should maintain 1200-1500mg per day)
3. Lactase enzyme supplements (Lactaid pills)

Colitis, Celiac disease, irritable bowel syndrome, and infections can also present with abdominal pain and diarrhea. Contact your primary physician for further information.

Now here are some interesting statistics:

1. Nearly 100% of American Indians and Asians have some degree of LI.
2. Nearly 75% of people worldwide have some degree of LI.
3. Up to 80% of African Americans and Hispanics have LI.
4. 30 to 50 million Americans suffer from LI
5. About 1 in 9 Americans have a form of LI.
6. Lactase levels start to decline around 4 years of age and decreases with age.

Hope this was informative and have a nice day!