Diagnosing Lactose Intolerance
Doctors usually diagnose lactose intolerance through a simple hydrogen breath test.
A person blows into a tube to give a sample of the breath, then gives another sample
after drinking a lactose solution or eating a lactose-containing food.
If someone has a lactose intolerance, the test will show that there is a higher
than average level of hydrogen and methane in the breath. That's because undigested
lactose leads to higher levels of these gases in the system, which can be detected
in the breath.
Certain foods, medicines, and exposure to cigarette smoking can affect the test's
accuracy, so the doctor might advise taking a few precautions before the test
is done.
Besides the breath test, doctors usually do a physical exam and take a full medical
history to rule out other medical conditions.
An endoscopy, which lets the doctor look at the esophagus, stomach, and part
of the small intestines using a tiny camera, also can be done to check for lactose
intolerance. In an endoscopy, the doctor may give the patient a medicine to help him
or her relax and may spray the throat to numb it. This makes the test more comfortable.
Most patients are given anesthesia and are "asleep" when this procedure is done.
The doctor then slides a thin, flexible plastic tube called an endoscope down the
throat and into the esophagus and the stomach. A tiny camera in the endoscope lets
the doctor look for abnormalities on the surface of the esophagus and stomach lining.
During the endoscopy, the doctor also may use small tweezers (forceps) to remove a
piece of tissue for biopsy. A biopsy can show damage caused by acid reflux or infection
and help rule out other problems.
Problems digesting lactose can also occur in people with other diseases of the
gastrointestinal tract, such as celiac
disease, a condition in which the intestine becomes damaged due to the person's
abnormal sensitivity to gluten (a protein found in wheat and certain other grains).
Living With Lactose Intolerance
Severity of lactose intolerance can vary widely between kids. Because each case
is different, there's no one simple way of dealing with it. Each child needs to find
what works best depending on the symptoms and how much, if any, lactase the body produces.
It may help to keep a food diary as you figure out what foods and drinks your child's
system can and can't handle.
Many foods, drinks, and digestive aids are available for those with a lactose intolerance
(like milk specifically made for people with this condition, which most supermarkets
carry). Ask your doctor if your child should supplement certain dairy products with
drops or tablets that contain the lactase enzyme.
While kids with the most severe cases may have to avoid all dairy products, doctors
now recommend that most have some dairy in order to get enough calcium, vitamin D,
and protein. Many kids can have small amounts of dairy products — which should
be consumed in combination with other foods that don't contain lactose — and
some can have one to two glasses of milk each day without any problems, especially
if consumed with non-dairy foods.
Also, kids with lactose intolerance may find that other dairy products, such as
yogurt and cheeses, are easier to digest than milk. Lactose-free milk is also a great
way to get calcium in your child's diet without the problems. A lactase enzyme supplement
can be used, too. Taking this before eating foods that contain dairy will help the
body digest the lactose sugar in dairy and prevent the symptoms of lactose intolerance,
like pain, cramping, bloating, gas, and diarrhea.
Encourage your child to eat other calcium-rich foods that don't have lactose, like
broccoli, collard greens, kale, turnip greens, salmon, almonds, soybeans, dried fruit,
fortified orange juice, and tofu.
Also, consider talking with a registered dietitian to come up with dairy alternatives
and a well-balanced diet that provides vital nutrients for your child.
Date reviewed: January 2015