We saw a patient in Urgent Care (Emergi-Care) for abdominal pain who had seen many doctors in the past including gastroenterologist. Dr. Usha Jain saw the patient who explored the problem in detail and decided to do basic tests again. The patient had blood drawn and stool tests were done to check for any infection.
The patient was advised to stop all the dairy products for one week and was also told to take lactaid tablets to take care of any lactose in the food like bread, cake etc.
The patient returned for follow up appointment in one week and felt much better. His abdominal pain was almost gone. The patient was advised to continue to not take dairy or he can take lactaid tablets with each meal.
The patient had been to gasteroenterologist and had endoscopy done but he was never treated for lactose intolerance.
Again the proper diagnosis and treatment is important. Simple treatment could have saved the patient from having to have lot of tests and going to many doctors without getting better.
Lactose tolerance is from the deficiency of lactase which is required to digest lactose which is a sugar in milk and dairy products. Lactase is an enzyme produced in small intestine. Usually your lactase production decreases with your age as your diet becomes more varied and less reliant on milk. This gradual decline may lead to symptoms of lactose intolerance. This is called primary lactose tolerance.
Secondary lactose tolerance occurs when your small intestine decreases lactase production after an illness, surgery or injury to your small intestine. It can occur as a result of intestinal diseases, such as celiac disease, gastroenteritis and an inflammatory bowel disease like Crohn’s disease. Treatment of the underlying disorder may restore lactase levels and improve signs and symptoms, though it can take time.
Causes of lactose Intolerance:
- Lactose intolerance becomes more common as you age
- Lactose intolerance is most common in black, Asian, Hispanic and American Indian people.
- Infants born prematurely may have reduced levels of lactase, because this enzyme increases in the fetus late in the third trimester.
- Small intestine problems that can cause lactose intolerance include bacterial overgrowth, celiac disease and Crohn’s disease.
- If you’ve received radiation therapy for cancer in your abdomen, you have an increased risk of lactose intolerance.
Treatment of Lactose Intolerance:
- Avoid Dairy products and replace milk with soy milk.
- Lactaid tablets (Lactase Enzyme). Over-the-counter tablets or drops containing the lactase enzyme may help you digest dairy products. You can take tablets just before a meal or snack. Or the drops can be added to a carton of milk. Not everyone with lactose intolerance is helped by these products.
- Probiotics: Probiotics are living organisms present in your intestines that help maintain a healthy digestive system. These are sometimes used for gastrointestinal conditions such as diarrhea and irritable bowel syndrome. They may also help your body digest lactose. Probiotics are generally considered safe.