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Is It Really Lactose Intolerance?

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An article titled “Demystifying Lactose Intolerance” in the April 2012 issue of Today’s Dietitian is geared toward increasing the knowledge base of registered dietitians. At the same time, it has plenty of good takeaway information for anyone dealing with the condition.

As digestive ailments go, lactose intolerance is frequently misdiagnosed and misunderstood, writes registered dietitian and consultant Densie Webb. Gas, cramps, bloating and diarrhea are the hallmarks of a patient’s inability to digest the milk sugar called lactose.

But symptoms like these can mask more serious conditions, such as irritable bowel syndrome, celiac disease and inflammatory bowel disease.

Webb’s article provides references for various studies into lactose intolerance and helps “demystify” its diagnosis and treatment. Also, she interviews Robin Plotkin, a registered dietitian and nutrition communications expert.

Here are five key points from the article, although if you have time to browse it, you will find even more:

1. Avoiding any and all dairy products if you think you are lactose-intolerant can be a problem, because you might miss out on the calcium, Vitamin D and other nutrients of dairy. Consider trying small amounts of dairy, such as half a cup of milk with a meal or snack. Then see what happens. If you don't experience problems for this, gradually increase to one cup.

2. Study grocery store aisles for such things as lactose-free milk, low-lactose cheese and fortified soy, almond and rice milk products. Look for products that contain between zero and 2 grams of lactose per serving.

3. Try chocolate milk, as some studies suggest it might be better tolerated than unflavored milk.

4. Consider probiotics, but realize that the National Institutes of Health has said research is as yet insufficient to endorse probiotics for lactose digestion. Also, the effectiveness of probiotics varies widely from one product to another.

5. Colonic adaptation might work for you. The idea is to routinely ingest lactose to see if you can build your tolerance for it. The article states that adults and adolescents who have been diagnosed with lactose malabsorption can tolerate at least 12 grams of lactose in a single dose. Generally, that’s one cup of milk.

There is additional straight talk about lactose intolerance on the website for the National Digestive Diseases Information Clearinghouse (NDDIC), where a section on symptoms explains that lactose intolerance can cause varying amounts of discomfort between 30 minutes and two hours after ingesting milk products.

You might be tempted to self-diagnose lactose intolerance when you are having digestive discomfort, but the NDDIC describes an easy test that can actually measure the digestion of lactose.

Called the hydrogen breath test, it involves drinking a lactose-loaded beverage and then measuring hydrogen, which goes up in the presence of undigested lactose.

The NDDIC also points out that certain processed foods contain small amounts of lactose, including bread, pancake mix, instant potatoes, chips, salad dressing and non-dairy coffee creamers.

A diet supervised by a registered dietitian or other health care professional can ensure you are getting adequate nutrients while minimizing digestive discomfort, the NDDIC says.


Webb, Densie. “Demystifying Lactose Intolerance -- Successful Treatment Begins With an Accurate Diagnosis.” Today’s Dietitian Magazine. Web. 12 April 2012. http://www.todaysdietitian.com/newarchives/040212p14.shtml

“Lactose Intolerance.” National Digestive Diseases Information Clearinghouse. Web. 12 April 2012. http://digestive.niddk.nih.gov/ddiseases/pubs/lactoseintolerance/index.aspx

Reviewed April 13, 2012
by Michele Blacksberg RN
Edited by Jody Smith

Add a Comment2 Comments

EmpowHER Guest

I would give this article a D-

The title is misleading, as only one sentence in the article relates to an alternative diagnosis. Additionaly, one of the key points made is the detriments of LI - that being the loss if calcium, vitamin D, etc., yet the suggested list of methods to combat LI fails to mention the most obvious and most culinarily and digestively satisfying: take a lactase enzyme supplement when eating dairy. A vast majority of sufferers can easily enjoy dairy products by taking a simple pill. How do you write an article on LI and not mention this?

April 22, 2012 - 9:15am
(reply to Anonymous)

Thanks for making your point about lactase enzyme supplements. Often in the interest of brevity I cannot list all the symptoms, causes, diagnostic methods and treatments for diseases and conditions. But anyone diagnosed with lactose intolerance certainly should ask for a doctor's advice on supplements.

April 23, 2012 - 2:33pm
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