Trouble with Dairy
By Antonia Pinckney, RD CDE RN
Lactose is the sugar naturally found in milk and other dairy products. It is digested in the small intestine by the lactase enzyme. Many people cannot make enough lactase. When they consume dairy products they may experience indigestion, abdominal pain, cramping, gas or diarrhea. This is called lactose intolerance. For some people the symptoms are mild and only occur after consuming large quantities of dairy. Others are more sensitive and have a difficult time even with small amounts of dairy products.
Some people suffer from lactose intolerance before bariatric surgery, while others experience it for the first time after surgery. In a normal stomach, dairy foods travel to the small intestine at a slow rate. This means only a small portion of the lactose from the dairy food will require digestion at one time. After surgery, food can sometimes leave the small stomach pouch faster without allowing enough lactase enzyme to be available for digestion.
Dairy products are an important source of protein and calcium. If you suffer from lactose intolerance, you may find the following strategies helpful. Look for lactose-free milk or soy milk. Many patients with lactose intolerance can digest yogurt. Additionally, hard cheese is usually tolerated better than softer cheese. Some whey protein supplements contain lactose. Individuals with lactose intolerance should select products containing whey protein isolate and should avoid products with whey protein concentrates. If the dairy foods still cause you symptoms, you may want to try an over the counter lactase enzyme to be consumed with your dairy foods.
Keep in mind that your dietary intake of calcium is only one source, but to meet your calcium needs you will most likely need a supplement. If you are only able to consume limited amounts of dairy foods and you do not like the substitutes, you may need to even more calcium in the form of supplementation.