Many people cannot drink milk without experiencing troubling and embarrassing stomach and digestive upsets. This problem may be caused by an allergy to cow’s milk or it may be an inability to digest the primary sugar in milk known as lactose.
If a patient cannot digest this sugar, he is known as lactose intolerant. Abdominal pain and altered bowel habits (usually diarrhea) after drinking or eating foods containing lactose are two of the most common problems for people with lactose intolerance.
People suffering from milk allergy also complain of nausea, bloating, gas, cramps, stomach rumbling and stool leakage. All of the symptoms are related to the person’s inability to absorb and use lactose in milk or food. This differentiates lactose intolerance from cow’s milk allergy, which is most often due to the proteins in milk.
Unfortunately, there is some overlap in the symptoms. Most infants with cow’s milk allergy will have diarrhea and mucus in the stools. About one-third of infants also suffer from colic, abdominal pain and excessive gas. These should also be symptoms of lactose intolerance.
However, the second most common symptom of cow’s milk allergy after diarrhea is vomiting, especially within one hour of feeding. Vomiting is not usually a symptom of lactose intolerance. If you are found to be lactose intolerant, a lactose restricted diet is the preferred treatment.
First, the patient removes all sources of lactose from the diet until symptom-free. Care must be taken to identify lactose through careful reading of all labels. For example, lactose is found in milk, ice cream, prepared party dips, sherbets, frozen dairy desserts, puddings, instant potatoes, prepared soups and some canned and frozen fruits and vegetables. Products that list milk sugars, casein, caseinate, whey or non-fat dry milk solids should be avoided.
After about three weeks, you may gradually increase lactose until you notice troubling symptoms. You may start with 1/4 cup of milk for breakfast. If there are no symptoms, increase to 1/2 cup the next morning. Keep increasing until symptoms appear, then drop back to the last level. Once the breakfast amount is set, you may repeat the same method for lunch and dinner.
Only about 5 to 10 percent of patients actually need total lactose restriction. It helps if you eat more small meals rather than a few larger ones. Also, take milk products with other foods to dilute the lactose.
You can also treat milk allergy by replacing the enzyme which helps the body digest milk. The enzyme, lactase, may be taken with meals or added to liquid dairy products. One product, Lactaid liquid, is added to milk in a ratio of four drops per quart of milk. The contents of another product, Lactrase capsules, can also be added to the milk (one to two capsules per quart). The milk is shaken and refrigerated for 24 hours to allow time for the enzyme to work. The milk will taste sweeter than normal.
A new product is called Dairty Ease lactose tablets, which are added to foods containing milk sugar.
Lactase liquid is only useful for milk used at home or taken from the home, but oral products may be taken before meals. You may find that one or more Lactrase capsules or one to three Lactaid tablets will allow you to eat or drink foods containing lactose without suffering unpleasant symptoms.
Special dairy products may provide some relief from milk allergy symptoms. For instance, a Lactaid lactose-reduced low-fat milk is available. It contains 70 percent less lactose than regular low-fat milk. However, cultured milks such as buttermilk do not improve lactose digestion or relieve symptoms. Unfermented milk containing acidophilus also fails to result in an improved condition. However, in several studies, yogurt has been shown to relieve symptoms of milk allergy.