Got milk? An increasing number of people are getting a funny feeling after cheesecake on Shavuos or having a queasy sensation when drinking the before-davening coffee or late-night chocolate. Others just have a hard time with the aftereffects of eating dairy products.
There’s a name for it. Lactose intolerance is the inability many people have digesting the sugars of milk, or lactose.
What is lactose and where is it found? Lactose is a type of sugar found in milk and other dairy products. Like other sugars, it requires a special enzyme to be digested. While there are many enzymes used to digest sugars, lactose is digested by lactase, a unique enzyme made in the small intestines. Unfortunately, many people do not have adequate amounts of lactase, leading to lactose intolerance. In fact, three-quarters of all Jews cannot digest this milk sugar, and this deficiency is primarily common amongst Ashkenazim.
How do you know if you are lactose intolerant? If you know you know! People with lactose intolerance do not feel well about an hour after eating dairy. They will experience nausea, cramps, stomach pain, gas, bloating or diarrhea. Children may have watery, frothy or bulky stools. Because the lactose is not properly digested in the small intestine, it ends up in the large intestine and gets digested by the bacteria that live there. This leads to all of the uncomfortable symptoms that lactose intolerant people have after that Shavuos cheesecake.
What tests diagnose lactose intolerance? The good news is that most lactose intolerance is diagnosed by personal history alone. If someone is experiencing consistent symptoms after eating dairy, the diagnosis is made. If the symptoms are severe, inconsistent, unclear if it appears only after dairy, or associated with any significant weight loss, a doctor may require some testing to rule out other causes. This may include bloodwork, a special breath test (called the hydrogen breath test) or, depending on the symptoms, even an endoscopy or colonoscopy.
I think I have lactose intolerance, now what? An easy way to test this is to take a break from eating dairy. If your symptoms improve, you have your answer. While avoiding dairy is challenging, it’s not impossible and there are many dairy substitutes for parve and fleishige meals. However, it’s also important to supplement some vital minerals which milk provides, particularly calcium and vitamin D. You may want to consider a multivitamin that has both. If you’re really missing that summer sundae, commercially available lactase enzyme preparations may be worth a try. While they don’t work for everyone, taking a Lactaid (or similar product) immediately prior to digesting dairy may help decrease symptoms in individuals with mild lactose intolerance.
There’s no use crying over spilled milk. There’s always soy.