How Do Doctors Diagnose It?
If your doctor thinks you might be lactose intolerant, he or she will take your
medical history by asking about any concerns and symptoms you have,
your past health, your family's health, any medications you're taking, any allergies
you may have, and other issues. Your doctor will also do a physical exam.
Doctors can test for lactose intolerance by using the hydrogen breath test. Normally
very little hydrogen gas is detectable in the breath. However, undigested lactose
in the colon ferments (breaks down) and produces various gases, including hydrogen.
If your doctor decides to give you a hydrogen breath test, you'll be asked to blow
into a tube for a beginning sample. You'll then swallow a drink with lactose in it,
wait a while, and breathe into the tube again. You'll be asked to blow into the tube
every half hour for 2 hours in order to measure hydrogen levels in your breath. The
levels should go up over time if you have lactose intolerance.
Doctors also can find out if you're able to digest lactose by testing for the presence
of lactase with an endoscopy. During this procedure, doctors view
the inside of the intestines by inserting a long tube with a light and a tiny camera
on the end into the mouth.
A doctor can then take tissue samples and pictures of the inside of your gut and
look for clues to why you've been having problems with what you're eating. The amount
of lactase enzyme can be measured in one of these tissue samples.
Living With Lactose Intolerance
Lactose usually can be easily managed if you're in tune with your body. Everyone's
different, but most people with lactose intolerance can eat a small amount of dairy.
The trick is to eat dairy products in combination with other foods that don't contain
lactose and not to eat too much dairy at once. It can also help to keep a food diary
to learn which foods your body can or can't tolerate.
Dairy foods are the best source of calcium,
a mineral that's important for bone growth. Because growing teens need about 1,300
milligrams (mg) of calcium each day, experts recommend that even teens who have lactose
intolerance continue to include some dairy in their diet.
Foods like cheese or yogurt may be easier to digest than milk, so try a cup of
yogurt for dessert or add a piece of cheese to your sandwich. Lactose-free milk is
also a great way to get calcium in your diet without the problems that can come with
lactose.
Taking a lactase enzyme supplement might help too. Taking this before eating foods
that contain dairy will help the body digest the lactose sugar in dairy so you don't
develop the symptoms of lactose intolerance, like pain, cramping, bloating, gas, and
diarrhea.
Teens with the most severe symptoms of lactose intolerance might have to avoid
all dairy products. It's extra important that these teens find other good calcium
sources, so talking to a registered dietitian is a good idea. Dietitians are trained
in nutrition and they can help people who are lactose intolerant come up with eating
alternatives and develop a well-balanced diet that provides lots of calcium for developing
strong bones.
Here are some tips for dealing with lactose intolerance:
- Choose lactose-reduced or lactose-free milk.
- Take a lactase enzyme supplement (such as Lactaid) just before you eat dairy products.
These can be taken in drops or tablets and even added directly to milk.
- When you do drink milk or eat lactose-containing foods, eat other non-lactose
foods at the same meal to slow digestion and avoid problems. (For example, if you
are going to have a milkshake, don't drink it by itself. Have something else with
it, like a healthy sandwich.)
- Drink juices that are fortified with calcium.
- Eat a variety of dairy-free foods that are rich in calcium, such as broccoli,
beans, tofu, or soy milk. Consider hard cheeses such as cheddar, which are lower in
lactose.
- Yogurts that contain active cultures are easier to digest and much less likely
to cause lactose problems.
- Learn to read food labels. Lactose
is added to some boxed, canned, frozen, and prepared foods like bread, cereal, lunchmeats,
salad dressings, mixes for cakes and cookies, and coffee creamers. Be aware of certain
words that might mean the food has lactose in it: butter, cheese, cream, dried milk,
milk solids, powdered milk, and whey, for example.
Date reviewed: January 2015