C.G. writes from Ganei Geula:
How do I know if I have milk intolerance and what can I do about it?

Published in The English Update, No.5, August 5 2010

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Milk contains a natural sugar called lactosePeople with milk intolerance (or “lactose intolerance”) are lacking an enzyme called lactase and cannot break down the lactose into a form they can digest. The lactase enzyme is located on the border of the bowel wall which separates the food in the gut from the inside of the body.

Lactose intolerance (or “LI” for short) can begin anytime after the age of two years old and into adulthood. Usually it is permanent but occasionally a temporary kind can occur, for example after a bad bout of infectious diarrhea. Rarely is someone born with this condition. LI is more common in Jews (both Sephardi and Ashkenazi) than in European non-Jewish populations.

The symptoms of LI include abdominal pain, fullness, bloating, gas, and diarrhea, especially after eating dairy products. These symptoms are also common to other conditions, such as irritable bowel syndrome and celiac disease. Diagnosis of LI by a physician involves a careful diet and medical history (among other things) to rule out other causes, and planned dietary manipulations.

The severity of symptoms varies, with some people unable to consume any dairy while others will only feel symptoms after drinking large quantities of milk. The symptoms can often get more severe over the course of time.

Laboratory tests can be ordered to support the diagnosis if the diagnosis is in doubt. In the most complicated cases, a colonoscopy is performed (looking in the bowel with a camera) and a small piece of the bowel wall is removed (as a “biopsy”), examined, and tested under a microscope. However, this procedure is rarely necessary in the management of most cases of LI.

It’s important to make sure that people with LI who cannot eat dairy have adequate calcium intake. Often the doctor will prescribe a supplement. Neglecting this need for calcium may lead to brittle bones (osteoporosis). People with LI should also eat non-dairy foods that are rich in calcium, such as green leafy vegetables, oily fish,
sprouts, tahina, and broccoli.

LI cannot be cured but patients can manage comfortably by avoiding or eating small amounts of dairy products. Other foods containing hidden lactose include some breads, salad dressings, and candies. Eating dairy/lactose together with other foods slows down its digestion which causes fewer symptoms. Lastly, it’s possible to
actually buy lactase, the enzyme that’s lacking. It comes in pill form from the pharmacy (as a food supplement), and this can relieve symptoms when eating dairy.

Dr Alexander King is a Family Doctor in the center of Jerusalem
For Appointments-call: *3555 (Maccabi)

If you have a question for Dr. King, email the299@gmail.com







Dr Alexander King,
Jan 8, 2011, 8:52 AM