FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

[NEW PRODUCT MAY HELP READER DIGEST TROUBLESOME DIARY PRODUCTS ]

Question: Everyone in my family is lactose intolerant. I've recently seen a new product called DairyCare advertised for those of us with this condition. Is it safe, and will it work?

Answer: Lactose intolerance is a very common digestive problem in adults that causes gas, bloating, and diarrhea after consuming dairy products. In order to nourish the body, lactose, the sugar in cows' milk, must be broken down into smaller fragments called monosaccharides so that they can be absorbed into the blood stream. Sometime between the age of 3 and 14, however, 75 percent of us lose the ability to make the lactase enzyme that breaks down the milk sugar. Therefore, we no longer can convert this milk sugar into a sugar our bodies can use. Because of this, any lactose that is consumed will pass on through the intestines without being digested.

The undigested lactose within the intestines causes digestive problems in two ways. First, the body shifts water into the intestines to dilute the lactose - about two quarts of water for each cup of milk, or its equivalent, consumed. This extra water causes the intestines to churn and move food residue along rapidly. This is the same effect laxatives have. As a consequence of this, people with lactose intolerance usually have a loud churning digestive system and also have frequent loose bowel movements.

The second symptom of lactose intolerance is a result of the undigested milk sugar passing through the small intestine into the colon. The colon is home to billions of bacteria, some of which can use this lactose as food. The important waste product from the bacterial metabolism of lactose is hydrogen gas. In fact, this happens so efficiently that the lactose in one cup of milk can make one gallon of hydrogen gas. No wonder people with this problem often complain of marked increase in intestinal gas!

Most of us occasionally have digestive upset similar to the symptoms of lactose intolerance. So how do you know if you have lactose intolerance? There are several ways, actually. One method involves drinking a lactose containing beverage - a big glass of milk - and then measuring the amount of hydrogen that is present in the exhaled breath. Another method involves consuming lactose and then measuring the blood sugar level. The most simple and least expensive, however, is to drink a large milk shake and see if you are plagued by gas, bloating and diarrhea in 30 minutes to 2 hours.

The problems of lactose intolerance can be avoided by simply avoiding lactose. In other words, no milk or milk products. However, some individuals are fairly comfortable if they restrict the amount of lactose they consume instead of totally eliminating it. Others find relief by consuming milk, ice cream and similar dairy products that have been treated with the lactase enzyme to reduce - but not totally eliminate - the amount of lactose that is present.

The bacterial action that changes milk into cheese and yogurt uses up some of the lactose, so these products may be tolerated without causing severe symptoms. The product you asked about, DairyCare, contains the bacteria Lactobacillus that normally lives in the intestines, and is also the bacteria that change milk into yogurt. Additionally, these bacteria produce the lactase enzyme which converts the milk sugar into a digestible sugar. So, this product works on two levels to help those who experience lactose intolerance. It is quite safe and may work particularly well if you have recently taken antibiotics.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.