My Tummy Hurts by Joseph Levy M.D

Author:Joseph Levy, M.D.
Language: eng
Format: epub
Publisher: Simon & Schuster
Published: 2004-07-15T00:00:00+00:00

Symptoms

Symptoms of lactose intolerance include nausea, cramps, bloating, gas, and diarrhea. These symptoms can arise from thirty minutes to two hours after eating or drinking something that contains lactose. The severity of the symptoms varies and depends on the amount of lactose an individual can tolerate.

Diagnosis

Lactose intolerance can de diagnosed by a lactose-tolerance test, a hydrogen breath test, or direct measurement of the enzyme activity in the small intestine.

Hydrogen Breath Test

As the name implies, the hydrogen breath test measures the concentration of hydrogen gas in exhaled breath. Normally, very little hydrogen is detectable in the breath and elevated levels of it can indicate lactose intolerance. This is because undigested lactose in the colon is fermented by bacteria, and various gases—including hydrogen—are produced. The hydrogen is then absorbed from the intestines, carried through the bloodstream to the lungs, and exhaled. If a lot of hydrogen is exhaled, that indicates fermentation is taking place, and the next step is to see if lactose might be the cause.

To prepare for the test, the child drinks a lactose dose equivalent to twelve to twenty-five ounces of milk, and the breath is analyzed at regular intervals while symptoms of gas, cramps, or diarrhea are recorded by the parents. If the test shows elevated levels of hydrogen in the breath, then lactose intolerance can be confirmed. (Certain foods, medications, and cigarettes can affect the test’s accuracy and should be avoided before taking the test.)

Because this test involves blowing air into a bag, however, some small children will have a hard time cooperating. (See chapter 5 for more details on the lactose breath test.) If lactose intolerance is suspected, the child can easily be put on a lactose-free or lactose-restricted diet, with parents observing any changes in symptoms. In other cases, if diagnosis of lactose intolerance needs to be confirmed in someone with symptoms of irritable bowel syndrome or other obscure complaints, the breath test can help us clear the issue in three hours.

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