Lactose Intolerance Page

Living with IBS &/or Lactose Intolerance
You may suffer from one or the other or both - there are many overlaps.  Once you learn your triggers and to avoid them you will feel so much better!  Understanding your own body and what makes it tick can change your life.  It changed mine.

People with lactose intolerance cannot metabolize lactose (the sugar found in milk & other dairy products) properly.  They lack lactase, an enzyme (produced in the small intestine) required in the digestive system to break down lactose.
Symptoms: excessive gas, bloating, diarrhea, abdominal pain, nausea and sometimes dehydration.

The bottom line: THERE ARE NO DO'S ONLY DONT'S!  This one's easy. Avoid foods with lactose!!!  Stay away!!

Foods Containing Lactose

milk

cream
butter
ice cream
sour cream
cheese and cheese culture
milk chocolate
(pure chocolate, with high cocoa aka cacao, content, doesn't contain lactose i.e. cocoa powder, bakers chocolate & cocoa butter.  Cocoa butter is not butter, it's vegetarian; the fat extract of the cocoa bean)
yogurt: some people can tolerate yogurt because it's got cultures that produce lactase to digest the lactose.
frozen yogurt: once yogurt is frozen though, it loses the cultures, so frozen yogurt will cause the same reaction as ice cream
bread and other baked goods
frozen products with breading, like french fries
candies
instant potatoes, breakfast drinks & soups
seasoning mixes
liquid & powdered milk-based meal replacements
margarine
powdered & liquid coffee creamers
non-dairy whipped toppings
potato chips, corn chips and other processed snacks
processed breakfast foods like cereals, donuts, waffles, pancakes
processed meats like bacon, lunch meats (cold cuts), hot dogs
(kosher cold cuts do not contain lactose)
protein powders, meal replacement powders, protein bars
salad dressings, tartar sauce
mixes for pancakes, biscuits & waffles

Note: Lactose is not only in dairy products!!! Lactose and milk are not synonymous!  Lactose is a type of sugar! It is very sneaky and stealthily hides in lots of things you never thought it would.  Lactose hides in many prepared foods and  many medications - prescription & over-the-counter  so read those labels! 

Watch words:  Read labels!  Watch out for products that list these as ingredients -
milk, lactose, whey, whey solids, whey protein, curds, milk by-products, dry milk solids, dairy solids, cream, non-fat dry milk powder, casein, sodium caseinate, ammonium  caseinate, calcium caseinate, potassium caseinate, caramel.

Some products labeled "non-dairy" may actually include ingredients derived from milk and contain lactose such as: powdered coffee creamer & whipped toppings.

Not everything starting with LACT means it has lactose. Lactalbumin, lactoglobulin & lactoferrin are whey/milk proteins and don't have lactose but people with a milk allergy should stay away from them.  (Milk protein is not the same thing as milk sugar (lactose) and milk allergy is not the same thing as lactose intolerance.) Lactylate, lactic acid, lactate do not contain lactose.
Check The Allergy Site for info on milk allergies/intolerances. (theallergysite.co.uk/dairy.html)

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Important Notes so Pay Attention!:
Most people in general are sensitive to some or all of the following sugars (in addition to lactose), so those with IBS & LI should be especially careful with them:


* Raffinose - in beans (ex: chick peas & hummus, kidney beans, lentils), cabbage, brussel sprouts, broccoli, asparagus, other veggies & whole grains.  It is sometimes known as melitose.

* Stachyose - in greenbeans, soybeans & other beans.

* Other Fructans -  artichokes, leeks, onions, garlic

* Soy contains 2 hard-to-digest-sugar compounds - raffinose + stachyose!  Lots of dairy subs are made with soy so be careful - you may also have a soy sensitivity!

* Fructose - in agave, honey, high fructose corn syrup, naturally in stone fruits (plums, apricots, cherries, peaches), apples, pears, grapes, artichokes, asparagus, watermelon, dried fruits (prunes, raisins, figs), onions, leeks, wheat, fruit juices & jams, sodas & sweet wine, foods with sorbitol and other polyols.

* Sweeteners: Sugar Alcohols a.k.a. Polyols, derived from plants are low digestible carbohydrates which means they are only partly absorbed during digestion.  That's a good thing in terms of not spiking your blood sugar but it makes them a trigger for intestinal problems.  Commonly added to foods because they have a lower calorie content and lower glycemic index than sugar (sucrose). They're used in lots of foods labeled, "sugar free".

They may cause SEVERE diarrhea, bloating and intestinal discomfort! 

 Read labels!

Sorbitol

Isomalt

Xylitol

Maltitol

Mannitol

Lactitol

Erythritol - Different from other sugar alcohols because it has a greater absorption rate so it causes less intestinal distress.

Hydrogenated Starch Hydrolysates- sometimes listed as maltitol, hydrogenated glucose syrup or HSH)

Artificial sweeteners: aspartame (NutraSweet & Equal), saccharin (Sweet'N Low), sucralose (Splenda).  Truvia made from stevia & erythritol seems to be better tolerated for IBS.

(Also avoid Carrageenan - (not a sugar) Some people are triggered by this food additive used as a thickener in ice cream, yogurt, cottage cheese & other processed foods including soy milk).

FYI - all of these sugars cause bloating & gas & other GI discomfort because foods that contain them cannot be digested by enzymes in the stomach or small intestines so they are not broken down until they make their way all the way to the large intestines where they are finally broken down, by bacteria, creating carbon dioxide, hydrogen and methane aka gas.  (Most people have a hard time digesting these other sugars.) It's not pretty but someone's gotta tell you the gaseous stinkin' truth!



Resources
Johns Hopkins overview of LI