Dear Dr. Garner,
I am 40 years old and never had a problem with my digestion. I have noticed during the past few weeks that whenever I drink milk or dairy products, I have indigestion. My husband tells me that I have lactose intolerance. I don’t even know what that means.
What do you think I should do?
Milk Pains in Midwood

Dear Milk Pains,
Lactose intolerance means that one’s body has trouble digesting milk and other dairy products.

A person may be born with lactose intolerance, or it may develop over time.
The intestines normally produce an enzyme (lactase) which helps to digest milk and dairy products.

For unknown reasons, over time, the production of this enzyme may decrease.
If it gets too low, the following symptoms may occur 30 minutes to two hours after eating dairy products which contain lactose:

• nausea

• cramps

• bloating

• gas

• diarrhea
 
Your doctor can order a test to determine if you have it. It is known as the hydrogen breath test. Another test is the stool acid test, where the stool is analyzed for how much acidity it has. Both these tests are easy to perform, without any discomfort.

At-Risk Groups 

There are certain groups at increased risk for lactose intolerance: African Americans, Asians, Hispanics, and American Indians.

No known way exists to increase the amount of the enzyme, but the symptoms can be controlled through diet.

Small children born with the deficiency should not be fed foods containing lactose. Fortunately, it is rare in those under five years of age.

Older children and adults need not avoid lactose completely. Inidividuals vary in how much lactose they can tolerate.

It is basically trial and error to see what foods and how much of them you can tolerate.

There is something known as “lactase additives” which you can get  in the drug store.

After putting a few drops in a quart of milk, and leaving it in the refrigerator for 24 hours, the lactose content is reduced by 70%. There is also a lactase tablet that helps people digest solid foods that contain lactose.

People can also buy lactose-reduced milk at most supermarkets. The milk contains all of the nutrients found in regular milk.

It is important to remember that calcium is a very important nutrient, needed for the growth and repair of bones throughout life.

A shortage may lead to brittle bones, or osteoporosis.

Calcium pills may be needed to provide the daily requirement (1500 mg per day).
Many green vegetables and fish have high amounts of calcium and can be tolerated by lactose intolerant people.

Yogurt may be a very good source of calcium for those who are lactose intolerant. The bacterial cultures in yogurt may produce the enzyme required for proper digestion of lactose.

While everyone recognizes dairy products and milk as a source of lactose, some other products may also contain it. These include:

• Bread

• Breakfast cereals

• Salad dressing

• Instant soups

• Pancake and cookie mix

• Powdered coffee creamer

• Prescription and over the counter drugs

It is important to read carefully the labels of the foods you eat.
 
There are some ways to help prevent or reduce the symptoms of lactose intolerance.

- Drink milk with meals and not on an empty stomach.

- Use low lactose cheeses.

- Eat yogurt with active live cultures.

- Pre-treat milk with over the counter lactose formulas.
 
Your husband may be correct in his diagnosis.

Sometimes lactose intolerance is a temporary condition which may be related to a stomach infection, a parasite, or even the stomach flu. Antibiotics and other medications may also temporarily bring on the problem.

A home do-it-yourself test can be tried which involves avoiding lactose-containing products for a few days. On a non-busy morning, drink two glasses of low fat or skim milk. If the symptoms arise, then there is a good chance you have lactose intolerance. 

Of course, it is essential to meet with your own doctor regarding your symptoms, as there are many other causes of indigestion and stomach pains, and some may be very serious.

I hope this helps you and others afflicted with this distressing condition.

What a Party! 

This past Friday evening was the 100th anniversary dinner for The Tablet.
It was great meeting so many of you, and there were many” Ask the Doctor” questions posed to me.

I thought I would briefly address the issue of cell phone use and dangers they might pose. Particularly interested in this topic were Pat Christiansen and Lilianne DeRosa, at whose table I was lucky to be seated.

The main difficulty in giving a definitive answer is that there just isn’t a long enough usage period to determine if there are increased brain tumors or other medical problems associated with cell phone use. Some medical problems such as brain tumors may take 10 or more years to develop.

A study reported last week, by a neurologist in London, predicted there would be more cancers from cell phones than cigarettes in the future. It was noted that worldwide, one billion people smoke and three billion people use cell phones. I believe this is an alarmist point of view, and greatly exaggerated.

On the other hand, I believe that people should take precautions in their use of cell phones, such as:

1. Limit time on cell phone, particularly for children.

2. Avoid excessive use of “blue tooth” headsets — it has been argued that the brain may function as an antenna in this set-up with possible increased risk.

3. Use ear phones which allow the phone to be placed away from the head, whenever possible.

4. Install a car antenna if use in your auto is excessive.

5. Ensure that the phone you use has the lowest output of radio frequency radiation. Ask your carrier or dealer.

The bottom line is that while cell phones are most likely safe to use, with little or no risk to one’s health, the full answer regarding their safety is not yet known.

Stay tuned for the studies to be reported over the next few years, and use common sense for now — everything in moderation.

I hope you all have a great week and stay well.

Dr. Steven Garner, MD, is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also is the host of “Ask the Doctor,” the call-in cable TV show seen locally on The Prayer Channel.