Lactose Intolerance

Prevention

There is no way to prevent lactose intolerance.

Treatment

There are two main ways to treat lactose intolerance:

• Reduce the amount of lactose you eat, by limiting milk and dairy products

• Take commercially available enzyme substitutes

People with lactose intolerance need to read labels of all prepared foods to these if they contain lactose. The highest concentrations are found in ice cream and milk. Cheeses typically have lower amounts of lactose. Some products listed as nondairy, such as powdered coffee creamer and whipped toppings, may contain lactose if they contain ingredients that are derived from milk. When you read food labels, look for words such as whey, curds, milk byproducts, dry milk solids and nonfat dry milk powder. If any of these ingredients are on the label, the product probably contains lactose.

If you completely avoid lactose, your symptoms should go away. If they do not, the diagnosis might not be correct. Many people will be able to tolerate a gradual increase in lactose intake if they are careful to monitor their symptoms. Doctors often recommend ice cream for this. It tends to be tolerated better than other foods that contain lactose because of its high fat content. As you gradually increase your lactose levels, review your diet with your doctor or a nutritionist to be sure that you are eating the proper proportions of fat, protein and other nutrients.

There are several commercially available enzyme formulations (tablets and liquids) that can serve as lactase replacements. You can add these to foods that contain lactose to reduce symptoms significantly. However, these products rarely get rid of symptoms completely, and the results vary among people and with different product formulations. Pretreated dairy products are an extremely effective alternative. You can add enzyme drops to milk and then refrigerate the milk for 24 hours before use or you can purchase dairy products that have been treated to reduce the lactose ("lactose-free" milk). Note that acidophilus milk still has too much lactose to be useful for most people with lactose intolerance.