If you have Celiac Disease, it’s good to be aware that lactose intolerance and Celiac Disease go hand-in-hand. When your gut is healing, it’s sometimes hard to determine where intestinal distress originates. This can be frustrating when you’re diligently eliminating gluten from your diet, but still experiencing symptoms. Before you’re tempted to give up on a gluten-free lifestyle, perhaps it’s time to explore the possibility of lactose intolerance.
Lactose is a sugar found in milk. This disaccharide is composed of two simple sugars – glucose and galactose. Our bodies use an enzyme called lactase to break down glucose. Lactase is secreted by the villi in the intestine. We produce more of this enzyme as infants because human milk is high in lactose, but some adults produce enough lactase to tolerate milk. Others do not. Those with Celiac Disease may have significant damage to the villi in the intestine. This can affect lactase secretion resulting in secondary lactose intolerance.
How do I know if I have lactose intolerance?
The symptoms of lactose intolerance include abdominal pain, bloating, gas, gurgling and rumbling, diarrhea, and nausea that appear on average from 30 minutes to two hours after consuming milk or milk products.
Depending on your sensitivity, you may not recognize that milk and milk products are causing the problem. The connection may not be as direct as drink one glass of milk = all symptoms appear. Your symptoms may be related to the amount of lactose you consume.
One cup of whole milk contains approximately 12 grams of lactose. That 12 grams may not cause symptoms, but an added bowl of ice cream may put you in distress.
Can I still drink milk?
Drinking milk may make you miserable, but it does not cause damage to your intestine even if you’re lactose intolerant. If you want to drink milk, but don’t want to take the risk of embarrassing symptoms, there are lactose-free dairy products available. Another option is to increase the lactase in your system by taking a lactase enzyme pill.
What should I avoid?
To limit your lactose intake, avoid:
Evaporated or Condensed Milk
Hot Chocolate Mixes
Cream or Milk Stout (beer)
Soft and Processed Cheeses like ricotta, cottage cheese, cream cheese, Farmers cheese, queso fresco, cheese foods or cheese spreads
Yogurt (unless you make it and let it ferment for at least 24 hours)
Mashed potatoes (unless you make them)
Bread, muffins, biscuits, rolls, pancakes, waffles, and crackers (read labels)
Cheese flavoring (read labels)
Other creamy salad dressings (read labels)
Can I have any dairy products?
Some dairy products have minimal amounts of lactose and are fine to consume. These include butter, aged cheeses like cheddar, Parmesan, provolone, or Swiss. Homemade yogurt that is allowed to ferment for 24 hours will break down all of the lactose into unharmful lactic acid. Fresh cheese made by draining this yogurt is also safe to consume. When in doubt, read the label, ask the chef, or make it yourself.
The easiest way to know whether your food contains dairy products is to make it yourself. In a restaurant, you can ask the chef or baker. If you have Celiac Disease, you most likely have lots of practice with this. You are also most likely an excellent label reader and are aware that milk is one of the top 8 allergens required to be listed on packaged products in the US.
It’s always disappointing to consider eliminating another category of foods if you’ve already eliminated gluten. At least with lactose, you have the option of taking enzymes to counteract the symptoms.
I’d have to say, I hate a stomach ache enough that I’m willing to endure lots of diet revisions in order to avoid one. I can’t think of a single roll, doughnut, cake, or even ice cream (and I love ice cream) worth the pain.
If you have Celiac Disease and continuing pain, it’s good to remember that Celiac Disease and lactose intolerance go hand-in-hand. This could be the secret to ending your abdominal pain.