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3 Sneaky Places Dairy Might Be Hiding

There are many people worldwide who have some degree of lactose intolerance. For some, the symptoms may be as mild as minor bloating and a little extra gas. For others, consuming dairy may result in more severe gastric distress or for those who have a true allergy, anaphylaxis can occur. Avoiding dairy products may seem simple, but there are a few places you may find dairy that would surprise you.

 

Chewing Gum

It sounds crazy, right? Most of the time, chewing gum is safe for lactose intolerant people, but there is one ingredient that could have a significant effect on those with a lactose allergy.  Recaldent is an additive that is derived from milk and is used by some brands of chewing gum to strengthen teeth’s enamel with calcium and phosphate. If you’re not sure, check with your doctor or dentist before using a new product for the first time.

 

Processed Meats

Processed meats are a food that should be a limited part of anyone’s diet. Fillers in certain types of processed meats (hot dogs and deli meat) may include whey, made from milk protein and lactose. An additional risk is meat that is cut on the same slicer as deli cheeses. Be cautious if you have issues with lactose intolerance or milk allergies.

 

Alcohol

If you’re a social or recreational drinker, you might want to think twice before reaching for a new beer or wine that you’ve never had before. Sometimes, milk and its derivatives are used in the process of making such beverages. Vegan alcoholic beverages will always be free of dairy and its derivatives.

 

For the most part, avoiding dairy foods like milk, yogurt, cheese, and ice cream will take care of most of your lactose intolerance symptoms. To stay symptom-free always check the ingredients label before purchasing a new food to avoid any unpleasant surprises.

 

Not sure if you are lactose intolerant? Check out the Symptoms of Lactose Intolerance to learn more. The specialists at Granite Peaks Gastroenterology can help you pinpoint the cause of your digestive health symptoms and help you make choices to keep you feeling your best.

The Holidays are on the Way – Keep Your Gut Health in Check!

Let’s face it. Many of us tend to over-indulge during the holidays. So many wonderful foods you only see at this time of year can be hard to pass up, but sometimes it’s worth the pass to not deal with the gas. Gas, bloating, acid reflux, and gut pain can all be part of the “joys” of the holidays if you suffer with digestive health challenges.

 

Be Mindful of Your Choices

Be aware of the foods you can’t seem to resist and think carefully about how you feel after you eat them. If you’re able to have a small amount of a favorite food, go for it! Enjoy every moment of the smell, taste and texture of that small serving. You’ll probably find the smaller serving is just right for you.

If you have a condition such as celiac disease or lactose intolerance, even small amounts of offending foods can be devastating to your digestive system. There are more fantastic gluten-free or lactose-free options for all types of foods than ever before at your local grocery store. You can have your treat and eat it too!

Foods high in sugar or sweeteners can make certain conditions, such as acid reflux, worse and they can have a negative effect on your gut and other organs. When you can, choose natural sweeteners in limited quantity to make your holiday treats sweet.

 

Don’t Make the Holiday a Drag

Shoot for the dishes you can enjoy without experiencing painful symptoms. To be sure you can enjoy your favorites by bringing safe dishes to share at important gatherings. Your host will love the help and you’ll have more fun!

Eating foods that taste great for a moment but take you out of the action aren’t going to help you enjoy your holidays. Aim for healthy foods that help you stay feeling your best. It will also help you keep your weight in check and avoid those extra holiday pounds.

 

When Your Digestive Issues Need Attention

If you have been having persistent digestive issues, now is the time to get checked out. Afterall, you can’t fix a problem if you’re not sure what the problem is. People sometimes suffer longer than necessary with symptoms such as acid reflux, stomach pain, diarrhea, constipation and other digestive ailments. See a gastroenterology specialist at Granite Peaks Gastroenterology to find the cause of your symptoms. An accurate diagnosis is the first step toward feeling your best, for the holidays and every day.

I’m Lactose Intolerant – What Are My Options?

Food – you need it to live, but if you eat the wrong thing it can cause some serious problems. Of course, what constitutes being the “wrong” thing differs from person to person. If you’ve been told that you are lactose intolerant, then for you, eating the wrong thing means consuming foods or beverages with lactose. So what are your options now?

Adjusting Your Diet

When it comes to dealing with lactose intolerance, the simple answer is to just not consume foods or drinks that have lactose in them. Lactose is a sugar that is made up of galactose and glucose and is found in milk. As such, it may be necessary to adjust your diet to exclude dairy products and other products that have dairy in them. Milk, cheese, yogurt, and ice cream are obvious. Less obvious foods to avoid may include bread, lunch meats, salad dressings, cereal, and baked good mixes.

Finding Good Sources of Calcium and Vitamin D

Part of the challenge of being lactose intolerant is that dairy products tend to be quality sources of both calcium and vitamin D. Cutting these foods out of your diet means you’ll need to find new sources. The good news is that there are plenty of ways to do that. You can find calcium in calcium-fortified beverages such as soy or almond milk, dark leafy greens like spinach and kale, and dried peas and beans. Oily fishes such as salmon and sardines, red meat, egg yolks, and fortified foods can be good sources of vitamin D.

Lactase Supplements

If the idea of no longer consuming foods or beverages that contain lactose is distasteful to you, the good news is that you don’t necessarily have to stop eating them, nor do you have to suffer the consequences of eating them as someone who is lactose intolerant. Lactose intolerance generally occurs due to a lack of lactase in the body. Lactase is an enzyme that breaks down lactose. It is available in an OTC supplement that can be taken with foods containing lactose to avoid the symptoms of lactose intolerance.

Consuming foods and beverages that contain lactose when you’re lactose intolerant isn’t likely to cause serious lasting harm, but it can make you extremely uncomfortable for a while, depending on how severe it is. Taking steps like adjusting your diet, finding other foods that are good sources of calcium and vitamin D, and taking lactase supplements are some of the things you can do to help you deal with being lactose intolerant. Remember, it’s up to you to decide what’s best for you.

Wondering if you’re lactose intolerant? Check out the different lactose intolerance tests you can take to find the answer.

What is Lactose Intolerance?

What is Lactose Intolerance?

If your body does not produce a sufficient level of lactase, the digestive enzyme needed to break down lactose, you may suffer symptoms of lactose intolerance. Your body does not make enough lactase to break down the sugar in milk products. The lactose is not digested in the small intestine, so it moves into the colon, undigested, which then causes uncomfortable symptoms.
This condition may be more common in adults. As we age, some of us naturally produce less lactase. Some ethnic groups are more prone to have low-to-no lactase production. Individuals who may have other digestive conditions such as Crohn’s disease, celiac disease, or infection may also show symptoms of lactose intolerance.

Symptoms of Lactose Intolerance

The good news is that lactose intolerance does not harm your intestines, but its uncomfortable symptoms are anything but good. Depending on the type and amount of lactose consumed, you may experience some of these symptoms:

  • Painful gas
  • Bloating
  • Diarrhea
  • Abdominal pain and cramping
  • Nausea or vomiting

4 Ways Lactose Intolerance Symptoms May Be Managed

Getting an accurate diagnosis of your condition is important. Often, individuals are not only lactose-intolerant but suffer with additional enzyme deficiencies. Testing for these deficiencies (disaccharidase deficiencies) may be necessary for accurate diagnosis and treatment. Seeing a gastroenterology specialist will ensure you are treating the right ailment and are implementing a complete and nutritionally adequate treatment plan for your condition.

Once a diagnosis is made, individuals with lactose intolerance may be able to control most symptoms with dietary changes.

1. Reduce Dairy

If your healthcare provider feels it’s appropriate, they might suggest eating smaller amounts of lactose-containing foods to determine whether smaller amounts may be well-tolerated.

2. Eliminate Dairy

If reducing lactose-containing foods does not work, a few common foods for those suffering from lactose intolerance to avoid are:

  • Milk
  • Ice Cream
  • Cheese
  • Sour Cream
  • Curds
  • Butter

*Watch for hidden sources of lactose including coffee creamers, bread and cereal, creamy salad dressings, pre-packaged mixes for making cookies, cake, or pancakes. There are brands now available that are safe for those who are lactose intolerant.

Continuing on a dairy-free diet may mean a lack of certain vitamins and minerals needed for adequate nutrition. Your gastroenterologist will provide a plan for you to get enough vitamin D, calcium and other minerals from your diet when you eliminate lactose-containing foods.

3. Use an Over-the-Counter Enzyme Supplement

For those who are significantly affected by even small amounts of lactose, over the counter medications such as Lactaid®, or generic versions of a lactase supplement may help. This medication is taken with or prior to eating lactose-containing food to ease and eliminate symptoms.

4. Lactose-Free Foods

Grocery stores have begun to regularly carry all sorts of food options for those with food allergies or specific eating styles. Affordable, lactose-free options are available in milk, cheese, and other dairy products. Lactose-free pre-packaged mixes and foods are also easy to fin. Watch the dairy-free label on the package.

Protect Your Calcium and Vitamin D Levels

If you are lactose intolerant, you may need to be more deliberate about your nutrition to maintain your calcium and vitamin D levels. Good food sources of calcium and vitamin D are:

  • Green leafy vegetables
  • Broccoli
  • Oranges
  • Dried Figs
  • Products made using fortified flour – such as bread and cereals
  • Dried peas and beans
  • Calcium fortified juices
  • Almonds, Brazil nuts
  • Soy, oat, almond or rice milk

Check with your Granite Peaks gastroenterology specialist if you are considering supplements to support your calcium and vitamin levels to be sure you are taking an appropriate amount for your age and your good health. As with any health condition, don’t go it alone! Talk to a specialist who can help you feel your best while addressing your specific health issues.

Are you Lactose Intolerant?

OVERVIEW
Lactose is the sugar found in milk and dairy products such as cheese and yogurt. After eating dairy products that contain this sugar, usually lactase, a digestive enzyme of the small intestine, helps to breakdown this complex sugar into two simple sugars, glucose and galactose. These simple sugars are then absorbed in the small intestine and ultimately reach the blood stream where they act as nutrients. The enzyme lactase is located in the lining of the small intestine known as the intestinal villi.

In addition to milk and dairy products such as ice cream, yogurt and cheese, lactose can be found in bread and baked goods, processed breakfast cereals, instant potatoes, some soups and non-kosher lunch meats, candies, dressings and mixes for pancakes and biscuits. Lactose is also the sugar found in breast milk and standard infant formulas. Therefore almost all babies are able to digest and absorb this sugar and it serves as their primary dietary sugar.

 

SYMPTOMS
Because lactose is not digested properly in the small intestine of individuals who are lactose intolerant, it passes whole into the large intestine or colon. Upon reaching the colon it is broken down by the normal colon bacteria. This breakdown results in the production of carbon dioxide and hydrogen gases. The gas production can lead to the following common symptoms:

  • • Abdominal distension and pain
  • • Excess burping
  • • Loud bowel sounds
  • • Excess gas and diarrhea following ingestion of lactose.
  • • Watery and explosive bowel movements
    • Urgency with bowel movements, which means that children feel that they have to get to the bathroom immediately or they will have an accident.

The symptoms of lactose intolerance can start during childhood or adolescence and tend to get worse with age. The severity of symptoms is usually proportional to the amount of the milk sugar ingested with more symptoms following a meal with higher milk sugar content.

Although eating lactose-containing products will result in discomfort for someone who is lactose intolerant, they are not at risk of developing more serious intestinal disease because of long-term lactose malabsorption. The only exception to this would be for babies who are born with primary lactase deficiency or children with secondary lactase deficiency as discussed below.

 

CAUSES
Primary Lactase Deficiency:
 This condition is very rare and occurs when babies are born with a deficiency or absence of the enzyme lactase. Babies inherit this condition by getting one gene that causes this problem from each of their parents, even though both parents may be lactose tolerant. These babies require a specialized formula with another type of sugar such as sucrose (present in table sugar), which they are able to digest.

Secondary Lactase Deficiency: The most common cause of temporary lactose intolerance in infants and young children is infection that affects the gastrointestinal tract and can damage the lining of the small intestine.

Rotavirus and Giardia are two common organisms that cause damage to the surface of the small intestine resulting in temporary lactose intolerance. Older infants and young children will commonly be infected by a rotavirus. The symptoms of rotavirus infection symptoms include vomiting, diarrhea (frequent, watery stools), and fever. Giardia is a parasite that is found in well water and fresh water from lakes and streams. Treatment of giardia infection with antibiotics will resolve the lactose intolerance.

Secondary lactase deficiency can also be due to Celiac disease, which is intolerance to gluten, the protein found in wheat, rye, barley and other grains. Crohn’s disease, an inflammatory condition that can affect any part of the gastrointestinal tract, can lead to secondary lactase deficiency as well. Once each of these conditions is treated, the lactase deficiency will resolve. The lactose intolerance usually resolves within three to four weeks when the lining of the intestines returns to normal.

Acquired Lactase Deficiency: Many individuals acquire lactose intolerance as they get older. It is estimated that approximately one-half of adults in the United States have acquired lactase deficiency. This condition is due to a normal decline in the amount of the enzyme lactase present in the small intestine as we age. Although lactose is an important part of the diet in infants and young children it represents only 10% of the carbohydrate (sugar) intake in adults. However, individuals who are lactose intolerant may not be able to tolerate even small amounts of this sugar in their diet.

Lactose intolerance occurs more frequently in certain families. One of the most important factors affecting the rate of developing lactose intolerance is an individual’s ethnic background. Approximately 15% of adult Caucasians, and 85% of adult African Americans in the United States are lactose intolerant. The rate of lactose intolerance is also very high in individuals of Asian descent, Hispanic descent, Native Americans and Jewish individuals.

 

DIAGNOSIS
Lactose intolerance is diagnosed by a simple test called a hydrogen breath test. After an overnight fast before the test, an individual breathes into a bag and then drinks a specified amount of the milk sugar in the form of a syrup. In adults this corresponds to the amount of milk sugar in a quart of milk. Subsequent breath samples are taken for up to three hours. The breath that they exhale into the bag is analyzed to determine its hydrogen content. During the course of the test individuals who are lactose intolerant will have an increase in the amount of hydrogen that they exhale. If the values for hydrogen increase above a certain value, the diagnosis of lactose intolerance is made. Patients who are lactose intolerant may also develop their typical symptoms during the test.

In younger children or in children who cannot tolerate the breath test, removal of lactose from the diet and possible supplementation with lactase can be done for 2-4 weeks to see if this improves the symptoms.

Treatment
The best treatment of lactose intolerance is a combination of dietary modification and taking a supplement to aid in digestion of lactose. Individuals who are lactose intolerant should meet with a dietician to review the sources of lactose in their diet. Some reduction in the daily lactose consumption is usually required. When an individual is going to be eating a food that contains lactose they should take a commercially available non-prescription lactase supplement at the time of lactose ingestion. This type of supplement can be taken throughout the day whenever lactose is ingested. Some individuals will be less lactose intolerant and therefore will be able to tolerate comparatively larger amounts of lactose. Alternatives to milk for lactose intolerant individuals include products such as soy milk. If an individual is restricting their milk/ dairy intake it is important to ensure adequate supplementation of calcium and Vitamin D in the diet. This is especially important for pediatric patients and women.

Recommended daily calcium intakes:
1-3 years of age: 500 mg
4-8 years of age: 800 mg
9-24 years of age: 1300 mg
Age 25 and above: 800-1000 mg
Pregnant and nursing women: 1200 mg

 

Author(s) and Publication Date(s)

Marsha H. Kay, MD, The Cleveland Clinic, Cleveland, OH, and Anthony F. Porto, MD, MPH, Yale University/Greenwich Hospital, Greenwich, CT – Updated December 2012.

Marsha H. Kay, MD, The Cleveland Clinic, Cleveland, OH, and Vasundhara Tolia, MD, Children’s Hospital of Michigan, Detroit, MI – Published September 2004.

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