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Emerald Group Publishing Limited
Copyright © 2011, Emerald Group Publishing Limited
Article Type: Food facts From: Nutrition & Food Science, Volume 41, Issue 3
A new survey, commissioned by Lactofree, has identified a potential “quick win” in terms of dealing with patients complaining of recurrent bouts of bloating, wind, nausea, diarrhoea and stomach cramps. Three quarters of GPs (76 per cent) faced with such symptoms would diagnose IBS, however, it is estimated that up to 20 per cent of IBS cases may actually be lactose intolerance. Furthermore, with half of GPs describing the condition in more general terms as “dairy intolerance”, patients are at risk of missing out on the important nutrients found in dairy produce by unnecessarily eliminating all dairy produce from their diets (instead of converting to lactose-free dairy products such as the Lactofree range); thereby damaging their long-term health and adding to GP workloads further down the line.
With only one in ten (11 per cent) GP surgeries in the UK benefiting from an in-house dietician, responsibility for diagnosis and management of food allergies and intolerances often falls to the GP. However, the symptoms of lactose intolerance can be similar to those associated with IBS, as well as a number of other conditions such as delayed milk protein allergy. In fact, the survey revealed that 60 per cent of GPs are unable to differentiate between lactose intolerance and delayed milk protein allergy, largely due to the lack of any validated tests for delayed allergies and the similarity of symptoms. Lactose intolerance occurs when a patient has a deficiency of lactase, an enzyme produced by the small intestine, which is responsible for breaking down lactose, the main sugar (carbohydrate) found in milk. Undigested lactose, therefore, passes through the gut into the large intestine where it is fermented by colonic bacteria, resulting in uncomfortable symptoms including stomach cramps and diarrhoea. Two-thirds of GPs also observe temporary lactose intolerance in patients, often following a disturbance to the normal function of the gut such as surgery, gastroenteritis, IBS, uncontrolled coeliac disease or cancer and its treatment.
Unlike lactose intolerance, cow’s milk protein allergy is an immune response, usually to one or more of the proteins found in milk. Depending on the antibodies involved it can have immediate and sometimes severe effects (where IgE antibody is present) or cause delayed gastrointestinal symptoms, which can be difficult to distinguish from lactose intolerance. A simple and effective elimination diet for your patients can be found at: www.lactofree.co.uk