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Health Hotline: Don't let lactose intolerance slow you down

Warm chocolate chip cookies with a tall glass of cold milk. A hot fudge sundae with whipped cream and a cherry. Your morning coffee with a hefty splash of cream. A cup of tomato soup alongside a gooey, decadent grilled cheese sandwich. This list of tasty foods might sound like a dream come true, but they add up to a nightmare - for a person with lactose intolerance.

Lactose is a type of sugar found in milk and other dairy products. It is digested by an enzyme called lactase in the small intestine. Lactose intolerance develops when the small intestine does not make enough lactase.

Lactose intolerance is common in adults and likelihood of developing lactose intolerance increases with age, as lactase activity tends to decrease in the adult years. It is estimated that about 30 million Americans have some degree of lactose intolerance by age 20. Certain populations, including Native Americans and people of Asian, African and South American descent are more likely to develop lactose intolerance than those of northern or western European backgrounds. Lactose intolerance also tends to run in families.

Lactose intolerance is not the same as a food allergy to milk. Symptoms of milk allergy are usually more severe. People with lactose intolerance often are able to digest limited amounts of milk and dairy products. Those with a milk allergy usually cannot drink or ingest any dairy products.

Symptoms of lactose intolerance often occur 30 minutes to two hours after ingesting milk products. Larger portions may cause more severe symptoms including: abdominal bloating and cramps, diarrhea, gas, nausea, vomiting and headache.

If you believe you have trouble digesting milk and dairy products and suspect you may have lactose intolerance, it's a good idea to talk about your symptoms with your primary care physician. Symptoms of lactose intolerance can also be signs of other intestinal problems such as irritable bowel syndrome and inflammatory bowel disease, so your doctor will ask you questions about your symptoms in order to make an accurate diagnosis. Your doctor may ask you to avoid dairy products for a short time to see if your symptoms improve. Other tests that gauge whether your body is digesting lactose may be used to make or confirm the diagnosis.

There is no cure for lactose intolerance, but there are a number of things you can do to decrease your symptoms.

+ Limit or avoid milk products. Many people find that certain milk products cause discomfort while other dairy products can be digested without any problems. For instance, buttermilk and cheeses have less lactose than milk.

+ Also, small servings of milk and dairy spread out throughout the day are typically easier to digest than larger servings consumed all at one sitting.

+ Products containing lactase enzymes are available to purchase and can be added to regular milk. You can buy lactose-reduced diary products or you can take a daily lactase supplement.

+ Combine milk products with other foods. Some people find that combining a solid food with a dairy product helps to reduce or eliminate symptoms.

+ Substitute non-dairy foods such as soy milk and soy cheese. Eat yogurt - especially yogurt with live cultures.

+ Read the label. Some foods and medications contain lactose. Breads, breakfast cereals, instant soups, salad dressings and candy can all contain lactose. Words to look for on the label include dry milk solids, whey, curds, milk by-products and nonfat dry milk power.

One concern for people with lactose intolerance is making sure they get enough calcium and other nutrients found in dairy products in their diet. Calcium keeps bones strong and reduces the risk of osteoporosis. Many non-dairy foods contain calcium, including: broccoli, dark leafy green vegetables such as spinach and collards, sardines, tuna, salmon, soybeans, rhubarb and almonds. Also, certain foods and juices can be purchased in a calcium-fortified form, such as orange juice and breakfast cereal.

Lactose intolerance can be a double-edged sword. The milk and dairy products that cause your symptoms contain valuable nutrients that you need to include in your diet. Over time, most people with lactose intolerance learn their triggers and how much dairy can be consumed without causing the symptoms of pain and discomfort. They also learn other ways to include nutrients like calcium and vitamin D in their diet so their bones - and bodies - stay healthy.

Dr. Burns is a board certified family practice physician at Raiter Clinic in Cloquet.