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Lactose intolerance – Diagnosis – NHS

It’s important to visit your GP if you think you or your child may have lactose intolerance, as the symptoms can be similar to other conditions.

Before seeing your GP, keep a diary of what you eat and drink, and what symptoms you experience.

Tell your GP if you notice any patterns or if there are any foods you seem particularly sensitive to.

Your GP may suggest trying to remove lactose from your diet for 2 weeks to see if it helps to relieve your symptoms.

This will provide further evidence of whether you’re lactose intolerant.

Further testing

Other tests are not usually needed, but your GP may sometimes suggest further tests to:

  • help confirm the diagnosis
  • find out how much lactase (the enzyme used to digest lactose) your body is producing
  • try to determine what might be causing your lactose intolerance

Some of the main tests that may be used are:

Hydrogen breath test

A hydrogen breath test is a simple way of determining if you may be lactose intolerant.

You’ll be asked to avoid eating or drinking during the night before the test.

When you arrive for the test, you’ll be asked to blow up a balloon-like bag. 

This sample of your breath will be tested to find out how much hydrogen is present, measured in parts per million (ppm).

You’ll then be given a drink of lactose solution and your breath will be tested every 15 minutes over the next few hours to see if the level of hydrogen changes.

If your breath contains a large amount of hydrogen (more than 20ppm above your baseline) after consuming the lactose solution, it’s likely that you’re lactose intolerant.

This is because lactose intolerance can cause the bacteria in the colon (large intestine) to produce more hydrogen than normal.

Lactose tolerance test

In a lactose tolerance test, you’ll be given a drink of lactose solution and a blood sample will be taken.

The blood will be tested to see how much blood sugar (glucose) it contains.

If you’re lactose intolerant, your blood sugar levels will either rise slowly or not at all.

This is because your body is unable to break down the lactose into glucose.

Milk tolerance test

In a milk tolerance test, you’ll be given a glass of milk (about 500ml) and your blood sugar levels will be tested.

If your blood sugar levels do not rise after drinking the milk, you may be lactose intolerant.

Small bowel biopsy

A small bowel biopsy is rarely used to diagnose lactose intolerance.

But it may be carried out to see if your symptoms are being caused by another condition, such as coeliac disease.

Lactose intolerance – Causes – NHS

Digesting lactose

After eating or drinking something containing lactose, the digested food passes from your stomach into your small intestine.

The lactase in your small intestine should break lactose down into sugars called glucose and galactose, which are then absorbed into your bloodstream.

If there’s not enough lactase, the unabsorbed lactose moves through your digestive system to your colon (large intestine).

Bacteria in the colon break down the lactose, producing fatty acids and gases like carbon dioxide, hydrogen and methane.

The breakdown of the lactose in the colon, and the resulting acids and gases that are produced, cause the symptoms of lactose intolerance, such as flatulence and bloating.

Types of lactase deficiency

Primary lactase deficiency

Primary lactase deficiency is the most common cause of lactose intolerance worldwide.

This type of lactase deficiency is caused by an inherited genetic fault that runs in families.

Primary lactase deficiency develops when your lactase production decreases as your diet becomes less reliant on milk and dairy products.

This is usually after the age of 2, when breastfeeding or bottlefeeding has stopped, although the symptoms may not be noticeable until adulthood.

Secondary lactase deficiency

Secondary lactase deficiency is a shortage of lactase caused by a problem in your small intestine.

It can occur at any age, and may be the result of another condition, surgery to your small intestine or taking certain medication.

Secondary lactase deficiency is the most common cause of lactose intolerance in the UK, particularly in babies and young children.

Possible causes of secondary lactase deficiency include:

The decrease in the production of lactase in secondary lactase deficiency is sometimes only temporary, but it may be permanent if it’s caused by a long-term condition.

It’s also possible to develop secondary lactase deficiency later in life, even without another condition to trigger it.

This is because your body’s production of lactase naturally reduces as you get older.

Congenital lactase deficiency

Congenital lactase deficiency is a rare condition that runs in families and is found in newborn babies.

It’s caused by an inherited genetic fault that means affected babies produce very little or no lactase.

The genetic mutation responsible for congenital lactase deficiency is passed on in an autosomal recessive inheritance pattern.

This means both parents must have a copy of the faulty gene to pass on the condition.

Find out more about genetic inheritance

Developmental lactase deficiency

Some babies born prematurely (before the 37th week of pregnancy) have a temporary lactose intolerance because their small intestine was not fully developed by the time they were born.

This is known as developmental lactase deficiency and usually improves as affected babies get older.

Lactose intolerance – Treatment – NHS

There’s no cure for lactose intolerance, but most people are able to control their symptoms by making changes to their diet.

Some cases of lactose intolerance, such as those caused by gastroenteritis, are only temporary and will improve within a few days or weeks.

Other cases, such as those caused by an inherited genetic fault or a long-term underlying condition, are likely to be long-lasting.

Changing your diet

In most cases, cutting down on or avoiding food and drink containing lactose and replacing them with lactose-free alternatives is enough to control the symptoms of lactose intolerance.

The exact changes you need to make to your diet depend on how sensitive you are to lactose.

Some people are able to tolerate some lactose in their diet without any problems, whereas others experience symptoms after consuming food containing only a tiny amount of lactose.

If you decide to experiment with what you can and cannot eat, make sure to introduce new foods gradually, rather than all at once.

This will help you get used to any foods you might be sensitive to, as well as identify any that cause problems.

Eating fewer products containing lactose, or avoiding them completely, can mean you miss out on certain vitamins and minerals in your diet and increase your risk of complications.

This means you’ll need to make sure you’re getting enough nutrition from either lacto-free foods or dietary supplements.

If you or your child are extremely sensitive to lactose, talk to your GP about your diet.

You may be referred to a dietitian, an expert in diet and nutrition, who can advise you about what foods should be included in your or your child’s diet.

Sources of lactose

Milk

A major source of lactose in our diet is milk, including cows’ milk, goats’ milk and sheep’s milk.

Depending on how mild or severe your lactose intolerance is, you may need to change the amount of milk in your diet.

For example:

  • you may be able to have milk in your tea or coffee, but not on your cereal
  • some products containing milk, such as milk chocolate, may still be acceptable in small quantities
  • you may find that drinking milk as part of a meal, rather than on its own, improves how the lactose is absorbed

Dairy products

Products made with milk, such as cream, cheese, yoghurt, ice cream and butter, also contain lactose and may need to be avoided if you’re lactose intolerant.

But the level of lactose in these products varies and is sometimes quite low, so you may still be able to have some of them without experiencing any problems.

It’s worth experimenting with different foods to find out if there are any dairy products you can eat, as they’re a good source of essential nutrients like calcium.

Other foods and drinks

As well as milk and dairy products, there are other foods and drinks that can sometimes contain lactose.

These include:

  • salad cream, salad dressing and mayonnaise
  • biscuits
  • chocolate
  • boiled sweets
  • cakes
  • some types of bread and other baked goods
  • some breakfast cereals
  • packets of mixes to make pancakes and biscuits
  • packets of instant potatoes and instant soup
  • some processed meats, such as sliced ham

Check the ingredients of all food and drink products carefully, as milk or lactose are often hidden ingredients.

The word “lactose” will not necessarily be listed separately on the food label, so you need to check the ingredients list for milk, whey, curds and milk products such as cheese, butter and cream.

Some ingredients may sound like they contain lactose when they do not, such as lactic acid, sodium lactate and cocoa butter.

These ingredients do not need to be avoided if you’re lactose intolerant.

Medication

Some prescription medicines, over-the-counter medicines and complementary medicines may contain a small amount of lactose.

While this is not usually enough to trigger the symptoms of lactose intolerance in most people, it may cause problems if your intolerance is severe or you’re taking several different medicines.

If you need to start taking a new medication, check with your GP or pharmacist in case it contains lactose.

Lactose-free foods and drinks

There are a number of alternative foods and drinks available in supermarkets to replace the milk and dairy products you need to avoid.

Food and drinks that do not usually contain lactose include:

  • soya yoghurts and cheeses
  • coconut-based yoghurts and cheeses
  • almond milk, yoghurts and cheeses
  • rice milk
  • oat milk
  • hazelnut milk
  • foods with the “dairy-free” or “suitable for vegans” signs
  • carob bars

Lactose-free dairy products

There are a number of lactose-free dairy products available to buy that are suitable for people with lactose intolerance.

These contain the same vitamins and minerals as standard dairy products, but they also have an added enzyme called lactase, which helps digest any lactose so the products do not trigger any symptoms.

Lactose-free versions of milk, yoghurt and cheese are normally available in larger supermarkets.

Getting enough calcium

If you’re unable to eat most dairy products, you may not be getting enough calcium in your daily diet. 

Calcium has several important functions, including:

  • helping build strong bones and teeth
  • regulating muscle contractions (including heartbeat)
  • ensuring blood clots normally

It’s a good idea to choose lactose-free products with added calcium and ensure your diet contains alternative sources of calcium, such as:

  • leafy green vegetables, such as kale, broccoli, cabbage and okra
  • soya beans
  • tofu
  • nuts
  • bread and anything made with fortified flour
  • fish containing edible bones (for example, sardines, salmon and pilchards)

You can also buy combined calcium and vitamin D supplements from most pharmacists to help maintain good bone health.

It’s important to check with your GP or dietitian whether you should be taking supplements, however, as taking excessively high levels of calcium can cause side effects.

Lactase substitutes

In addition to dietary changes, you may also find it useful to take liquid drops, tablets or capsules that contain lactase substitutes. These are available from most health foods shops.

Lactase substitutes replace the lactase your small intestine is not producing, which can reduce your symptoms by helping your body break down any lactose in your diet more easily.

Lactase substitutes can either be added to milk or taken just before eating a meal containing lactose.

Lactose intolerance in children

If your child is lactose intolerant, they may be able to consume small amounts of lactose without experiencing symptoms.

This is quite safe, but you may need to experiment to find out how much they can comfortably eat or drink.

If your child is unable to tolerate any lactose, your doctor may refer you to a dietitian for nutritional advice.

This is because it’s important for young children to have certain nutrients in their diet to ensure healthy growth and development.

In general, the same rules about foods to try or avoid are similar for children and adults.

For babies with lactose intolerance, lactose-free formula milk is available to buy from pharmacies and supermarkets.

But soya formula is not recommended for children under 6 months because it contains hormones that may interfere with your baby’s future physical and sexual development.

Breastfed babies may benefit from lactase substitute drops to help their bodies digest the lactose in breast milk.

For many children, lactose intolerance is only temporary and will improve after a few weeks.

After this point, it’s safe to gradually reintroduce milk and dairy products into their diet.

Advice for breastfeeding women

It’s perfectly safe to breastfeed your child if you’re lactose intolerant.

It does not put them at greater risk of becoming lactose intolerant and has important health benefits for your baby.

Find out more about the benefits of breastfeeding

Page last reviewed: 25 February 2019
Next review due: 25 February 2022

Lactose Intolerance Symptoms, Tests, and Diagnosis

Thirty minutes have passed since you ate a bowl of ice cream, and now your stomach is cramping and gassy. You feel like you might have diarrhea. Does this sound like you? Or, you had milk, mashed potatoes, or even candy almost 2 hours ago and have these symptoms. Does that sound like you? If either does, you could have lactose intolerance.

Lactose is the main sugar in milk and most other dairy products. Your small intestine makes the enzyme lactase to help you digest that sugar. When you’re lactose intolerant, you don’t make enough lactase to digest lactose well.

You can’t cure lactose intolerance, but if you change what and how you eat, you may get rid of your symptoms.

Ease Your Symptoms

Millions of Americans have symptoms of lactose intolerance:

You can use trial and error to find out what foods cause symptoms, and in what amount. And then check in with your doctor for a diagnosis. You may be sensitive to small amounts of foods that have lactose, or you may only have symptoms if you eat a lot of lactose foods. Your symptoms may be severe or mild. Lactose intolerance is different for everyone

Types and Causes

There are four types of lactose intolerance, and they all have different causes.

  • Primary lactose intolerance is the most common form. Our bodies typically stop making lactase by about age 5 (as early as age 2 for African Americans). As lactase levels decrease, dairy products become harder to digest. People with primary lactose intolerance make a lot less lactase. That makes dairy products hard to digest by adulthood. It’s caused by genes and is common among people of an African, Asian, Hispanic, Mediterranean, and southern European background. It’s less common if your heritage is from northern or western Europe.
  • Secondary lactose intolerance happens because of an injury, illness, or possibly a surgery. Any of these can affect your small intestine and cause you to make less lactase. Celiac disease and Crohn’s disease are two of the most common intestinal diseases linked to low lactase.
  • Developmental lactose intolerance happens in babies who are born prematurely. It usually goes away on its own, lasting for only a short time after birth.
  • Congenital lactose intolerance is very rare and happens when no lactase (or a very small amount of it) is produced by the small intestine from birth. It’s a genetic disorder, and both parents have to pass the gene on to their child.

 

Find the Culprits (Hint: It might not just be dairy.)

Lactose intolerance is not the same as a dairy allergy. The two are often confused. If you have a dairy allergy, you’re allergic to certain proteins in milk and dairy products. Dairy allergy reactions can be life-threatening.

The symptoms of lactose intolerance are less severe than those of a dairy allergy. People with a dairy allergy need to avoid all foods and drinks that contain milk or other dairy products. If you’re lactose intolerant, you may be able to eat and drink small amounts of dairy products. How much varies from person to person. Lactose intolerance reactions aren’t life-threatening.

Milk and dairy products are the best-known lactose foods, but there are many others. Some nondairy products have a protein called casein, which can have traces of lactose. To avoid symptoms from lactose intolerance, read food labels carefully. When shopping or cooking, look for these ingredients that have lactose:

  • Curds
  • Dry milk solids
  • Milk
  • Milk byproducts
  • Dry milk powder
  • Whey

If you are highly sensitive to lactose, you may need to avoid foods such as:

  • Baked goods
  • Bread, baking, and pancake mixes
  • Breakfast cereals
  • Certain types of candy, such as milk chocolate
  • Instant foods (breakfast drink mixes, mashed potatoes, soups, and meal replacement drinks)
  • Margarine
  • Nondairy creamers (liquid and powdered)
  • Nondairy whipped topping
  • Processed meats (bacon, hot dogs, sausage, and lunch meats)
  • Protein and meal replacement bars
  • Salad dressing

 

Get a Diagnosis

Your doctor may ask you to keep a diary of the foods you eat, to note when you have symptoms, and to stop eating an offending food to see if your symptoms go away. To help make a diagnosis, some doctors simply look at your symptoms and whether avoiding dairy products for 2 weeks relieves them.

To confirm the diagnosis, your doctor may do other tests, such as:

Hydrogen breath test. Normally, people have very little hydrogen in their breath. If your body doesn’t digest lactose, though, hydrogen builds in your intestines, and after a while it’s in your breath. This test measures how much hydrogen is in your breath after you have a lactose-loaded drink several times in a few hours. If your levels are high 3 to 5 hours later, your body does not digest lactose well.

Lactose tolerance test. When your body breaks down lactose, it releases sugar into your blood. This tests how much sugar is in your blood. After you fast, a small sample of blood is taken. Then, you drink a liquid that is high in lactose. Two hours later, you give another blood sample. Because lactose causes blood sugar levels to rise, your blood sugar levels in this sample should be higher. If you’re lactose intolerant, you’ll have just a low rise in blood sugar. But this test is rarely done any more.

How to Manage Lactose Intolerance

You can’t change how well your body digests lactose, but you can cut or even stop your symptoms.

Talk with your doctor or a registered dietitian who can help you plan a healthy diet that keeps you feeling good. Keep a food diary to help you learn how much (if any) dairy you can eat without having symptoms. Many people don’t need to stop eating all dairy.

If you make small changes in what you eat, you may be able to prevent symptoms by helping your body digest dairy foods easier.

Don’t eat dairy alone. It’s easier for your body to digest lactose when you eat it with other foods. So try having small amounts of milk or dairy foods with meals.

Choose easier-to-digest dairy products. Some people find it easier to digest dairy products like cheese, yogurt, and cottage cheese.

Use lactose-free or reduced-lactose milk and dairy products. You can find dairy products with most of the lactose removed, or lactase added, at many grocery stores.

Switch to dairy-free products. There are many nondairy options, such as almond, rice, or soy milks. Special note about infants and young children: When babies have symptoms of lactose intolerance (although it’s rare in children under age 6), pediatricians advise changing from cow’s milk formula to soy milk formula until the symptoms go away, then slowly adding cow’s milk formula and dairy products back into their diets.

Take a lactase enzyme replacement. These are available over the counter in pills or capsules. Take the advised dose with your first drink or bite of dairy to help prevent lactose intolerance symptoms.

Lactose Intolerance (for Teens) – Nemours Kidshealth

What Is Lactose Intolerance?

Lactose intolerance is when someone has trouble digesting lactose, a type of sugar found in milk and other dairy foods.

If people with lactose intolerance eat dairy products, the lactose from these foods pass into their intestines, which can lead to gas, cramps, a bloated feeling, and diarrhea.

Some people can have small amounts of dairy without problems. Others have a lot of stomach trouble and need to avoid all dairy products. Many foods, drinks, and digestive aids are available to help manage lactose intolerance.

What Happens in Lactose Intolerance?

Normally, when we eat something containing lactose, an enzyme in the small intestine called lactase breaks it down into simpler sugar forms called glucose and galactose. These simple sugars are then absorbed into the bloodstream and turned into energy.

In lactose intolerance, the body doesn’t make enough lactase to break down lactose. Instead, undigested lactose sits in the gut and gets broken down by bacteria, causing gas, bloating, stomach cramps, and diarrhea.

Lactose intolerance is fairly common. Kids and teens are less likely to have it, but many people eventually become lactose intolerant in adulthood. Some health care providers view lactose intolerance as a normal human condition and not a disease or serious health problem.

Besides age, people can become lactose intolerant due to:

  • Ethnic background. People of Asian, African, Native American, and Hispanic backgrounds are more likely to develop lactose intolerance at a young age.
  • Other problems with the digestive tract. People who have inflammation of their upper small intestine, such as celiac disease or Crohn’s disease, have less of the lactase enzyme.
  • Medicines. Some antibiotics can trigger temporary lactose intolerance because they affect how the intestine makes lactase.
  • Infection. After a bout of infectious diarrhea, some people can develop a temporary lactose intolerance that usually improves after a few days or weeks.

What Are the Signs & Symptoms of Lactose Intolerance?

Lactose intolerance can cause a variety of symptoms. It all depends on how much dairy or milk-containing foods people consume and how little lactase their body makes.

Usually within 30 minutes to 2 hours after eating, someone with lactose intolerance will have:

  • nausea
  • stomach cramps
  • bloating
  • gas
  • diarrhea

How Is Lactose Intolerance Diagnosed?

If you might have lactose intolerance, the docto will ask your symptoms and diet. They might test the breath for hydrogen levels before and after you drink lactose. Normally very little hydrogen gas is detectable in the breath. But undigested lactose in the colon breaks down and makes various gases, including hydrogen.

If you have a hydrogen breath test, you’ll blow into a tube for a beginning sample. Then you’ll swallow a drink with lactose in it, wait a while, and breathe into the tube again. You’ll blow into the tube every half hour for 2 hours to measure hydrogen levels. The levels should go up over time if you have lactose intolerance.

Doctors also can find out if someone can digest lactose by testing for the presence of lactase with an endoscopy. During this procedure, doctors view the inside of the intestines by inserting a long tube with a light and a tiny camera on the end into the mouth.

A doctor can then take tissue samples and pictures of the inside of the gut. The amount of lactase enzyme can be measured in one of these tissue samples.

How Is Lactose Intolerance Treated?

People can manage lactose intolerance by not drinking as much milk and eating fewer dairy products. Most can eat a small amount of dairy. But they need to eat it with other foods that don’t contain lactose and not eat too much dairy at once.

You may find that other dairy products, such as yogurt and cheeses, are easier to digest than milk. Lactose-free milk is also a great way to get calcium in the diet without the problems. It can also help to keep a food diary to learn which foods you can or can’t tolerate.

A lactase enzyme supplement can help too. Taking this before you eat foods that contain dairy helps your body digest the lactose sugar in dairy and prevent pain, cramping, bloating, gas, and diarrhea.

What About Calcium?

Dairy foods are the best source of calcium, a mineral that’s important for bone growth. Because teens need about 1,300 milligrams (mg) of calcium each day, experts recommend that even those with lactose intolerance include some dairy in their diet.

You also can eat non-dairy products like:

  • calcium-fortified juice or soy milk
  • green, leafy vegetables like broccoli, collard greens, kale, and turnip greens
  • beans
  • salmon
  • almonds
  • soybeans
  • dried fruit
  • tofu

Talking to a registered dietitian is a good idea. They’re trained in nutrition and can you come up with eating alternatives and develop a well-balanced diet that provides lots of calcium for developing strong bones. Some teens might need calcium and vitamin D supplements.

What Else Should I Know?

Here are some tips for dealing with lactose intolerance:

  • Choose lactose-reduced or lactose-free milk.
  • Take a lactase enzyme supplement (such as Lactaid) just before you eat dairy products. These can be taken in drops or tablets and even added directly to milk.
  • When you do drink milk or eat lactose-containing foods, eat other non-lactose foods at the same meal to slow digestion and avoid problems. (For example, if you are going to have a milkshake, don’t drink it by itself. Have something else with it, like a healthy sandwich.)
  • Drink juices that are fortified with calcium.
  • Eat a variety of dairy-free foods that are rich in calcium, such as broccoli, beans, tofu, or soy milk. Consider hard cheeses such as cheddar, which are lower in lactose.
  • Yogurts that contain active cultures are easier to digest and much less likely to cause lactose problems.
  • Learn to read food labels. Lactose is added to some boxed, canned, frozen, and prepared foods like bread, cereal, lunchmeats, salad dressings, mixes for cakes and cookies, and coffee creamers. Be aware of certain words that might mean the food has lactose in it: butter, cheese, cream, dried milk, milk solids, powdered milk, and whey, for example.

Lactose Intolerance | Johns Hopkins Medicine

What is lactose intolerance?

Lactose intolerance is when your body can’t break down or digest lactose. Lactose is a sugar found in milk and milk products.

Lactose intolerance happens when your small intestine does not make enough of a digestive enzyme called lactase. Lactase breaks down the lactose in food so your body can absorb it. People who are lactose intolerant have unpleasant symptoms after eating or drinking milk or milk products. These symptoms include bloating, diarrhea and gas.

Lactose intolerance is not the same thing as having a food allergy to milk.

Lactose intolerance is most common in Asian Americans, African Americans, Mexican Americans, and Native Americans.

What causes lactose intolerance?

Both children and adults can have lactose intolerance. Here are some common causes of this condition:

  • Lactose intolerance often runs in families (hereditary). In these cases, over time a person’s body may make less of the lactase enzyme. Symptoms may start during the teen or adult years.
  • In some cases, the small intestine stops making lactase after an injury or after a disease or infection.  
  • Some babies born too early (premature babies) may not be able to make enough lactase. This is often a short-term problem that goes away.
  • In very rare cases, people are born with an inability to make any lactase at all.

What are the symptoms of lactose intolerance?

Each person’s symptoms may vary. Symptoms often start about 30 minutes to 2 hours after you have food or drinks that have lactose.

Symptoms may include:

  • Belly (abdominal) cramps and pain
  • Nausea
  • Bloating
  • Gas
  • Diarrhea

How severe your symptoms are will depend on how much lactose you have ingested and how much lactase your body makes.

The symptoms of lactose intolerance may look like those of other health problems. Always see your healthcare provider to be sure.

How is lactose intolerance diagnosed?

Your healthcare provider will talk to you about your past health and family history. He or she will give you a physical exam.

You may be asked not to have any milk or milk products for a short time to see if your symptoms get better.

Some tests can help your doctor check for lactose intolerance. These may include:

  • Lactose tolerance test. This test checks how your digestive system absorbs lactose. You will be asked not to eat or drink anything for about 8 hours before the test. This often means not eating after midnight. For the test, you will drink a liquid that contains lactose. Some blood samples will be taken over a 2-hour period. These will check your blood sugar (blood glucose) level. If your blood sugar levels don’t rise, you may be lactose intolerant.
  • Hydrogen breath test. You will drink a liquid containing a lot of lactose. Your breath will be checked several times. High levels of hydrogen in your breath may mean you are lactose intolerant.
  • Stool acidity test. This test is used for infants and young children. It checks how much acid is in the stool. If someone is not digesting lactose, their stool will have lactic acid, glucose, and other fatty acids.  

How is lactose intolerance treated?

There is no treatment that can help your body make more lactase. But you can manage your symptoms by changing your diet.

In the past, people who were lactose intolerant were told to avoid dairy products. Today, health experts suggest you try different dairy foods and see which ones cause fewer symptoms. That way you can still get enough calcium and other important nutrients.

Lactose intolerance symptoms can be unpleasant, but they won’t hurt you. So try to find dairy foods that don’t cause severe symptoms.

Here are some tips for managing lactose in your diet:

  • Start slowly. Try adding small amounts of milk or milk products and see how your body reacts.
  • Have milk and milk products with other foods. You may find you have fewer symptoms if you take milk or milk products with your meals. Try eating cheese with crackers or having milk with cereal.   
  • Eat dairy products with naturally lower levels of lactose. These include hard cheeses and yogurt.
  • Look for lactose-free and lactose-reduced milk and milk products. These can be found at many food stores. They are the same as regular milk and milk products, but they have the lactase enzyme added to them.
  • Ask about lactase products. Ask your healthcare provider if you should take a lactase pill or lactase drops when you eat or drink milk products.

If you have trouble finding dairy products that don’t cause symptoms, talk to your healthcare provider. He or she can suggest other foods to be sure you get enough calcium. You may need to take calcium supplements.

Children with lactose intolerance should be seen by a healthcare provider. Children and teenagers need dairy foods. They are a major source of calcium for bone growth and other nutrients essential to children’s health and development.

Living with lactose intolerance

Lactose intolerance can affect you every time you eat a snack or meal. So you need to be careful about the foods you eat every day. However, many people can tolerate a certain amount of lactose and don’t need to completely avoid it.

It’s important to read food labels. Lactose is often added to some boxed, canned, frozen, and prepared foods such as:

  • Bread
  • Cereal
  • Lunch meats
  • Salad dressings
  • Cake and cookie mixes
  • Coffee creamers

Check food labels for words that may mean a food has lactose in it, such as:

  • Butter
  • Cheese
  • Cream
  • Dried milk
  • Milk solids
  • Powdered milk
  • Whey

When should I call my healthcare provider?

Call your healthcare provider if you have trouble managing your symptoms. Some symptoms can be embarrassing. Your healthcare provider can work with you to help keep them under control.

Symptoms & Causes of Lactose Intolerance

What are the symptoms of lactose intolerance?

If you have lactose intolerance, you may have symptoms within a few hours after you have milk or milk products, or other foods that contain lactose. Your symptoms may include

Your symptoms may be mild or severe, depending on how much lactose you have.

If you have lactose intolerance, you may have symptoms within a few hours after you have foods or drinks
that contain lactose.

What causes lactose intolerance?

Lactose intolerance is caused by lactose malabsorption. If you have lactose malabsorption, your small intestine makes low levels of lactase—the enzyme that breaks down lactose—and can’t digest all the lactose you eat or drink.

The undigested lactose passes into your colon. Bacteria in your colon break down the lactose and create fluid and gas. In some people, this extra fluid and gas causes lactose intolerance symptoms.

In some cases, your genes are the reason for lactose intolerance. Genes play a role in the following conditions, and these conditions can lead to low levels of lactase in your small intestine and lactose malabsorption:

  • Lactase nonpersistence. In people with lactase nonpersistence, the small intestine makes less lactase after infancy. Lactase levels get lower with age. Symptoms of lactose intolerance may not begin until later childhood, the teen years, or early adulthood. Lactase nonpersistence, also called primary lactase deficiency, is the most common cause of low lactase levels.
  • Congenital lactase deficiency. In this rare condition, the small intestine makes little or no lactase, starting at birth.

Not all causes of lactose intolerance are genetic. The following can also lead to lactose intolerance:

  • Injury to the small intestine. Infections, diseases, or other conditions that injure your small intestine, like Crohn’s disease or celiac disease, may cause it to make less lactase. Treatments—such as medicines, surgery, or radiation therapy—for other conditions may also injure your small intestine. Lactose intolerance caused by injury to the small intestine is called secondary lactose intolerance. If the cause of the injury is treated, you may be able to tolerate lactose again.
  • Premature birth. In premature babies, or babies born too soon, the small intestine may not make enough lactase for a short time after birth. The small intestine usually makes more lactase as the baby gets older.

What is the difference between lactose intolerance and milk allergies?

Lactose intolerance and milk allergies are different conditions with different causes. Lactose intolerance is caused by problems digesting lactose, the natural sugar in milk. In contrast, milk allergies are caused by your immune system’s response to one or more proteins in milk and milk products.

A milk allergy most often appears in the first year of life, while lactose intolerance typically appears later.3,4 Lactose intolerance can cause uncomfortable symptoms, while a serious allergic reaction to milk can be life threatening.

References

[3] Luyt D, Ball H, Makwana N, et al; Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI). BSACI guideline for the diagnosis and management of cow’s milk allergy. Clinical and Experimental Allergy. 2014;44(5):642–672.

[4] Bayless TM, Brown E, Paige DM. Lactase non-persistence and lactose intolerance. Current Gastroenterology Reports. 2017;19(5):23.


This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.

The NIDDK would like to thank:
Rachel Fisher, M.S., M.P.H., R.D., NIDDK Office of Nutrition Research

90,000 Good pizza, Great pizza recipes

Welcome to Gadgetplay my dear pizza makers and owners of pizzerias! Over the past few days, I have cooked up a whole mountain of all kinds of pizzas and am ready to share with you my experience in their production! Ahead of you awaits a couple of tips, an analysis of incomprehensible and complex recipes and, of course, answers to the riddles of the Sousovids! Go!

Tips.

1. Accuracy.

Make your pizzas carefully, for every sixth of a pizza you need to put three toppings and nothing else! Better to buy “Markup for Beginners” right away for 100 gold coins! For sloppy pizza, customers can get their money back!

NEVER PLACE THE FILLING ON THE CRUST!

2.Speed.

A neat and quick pizza will bring you gold coins and a good tip. With money and coins, you can buy upgrades and decorations for your pizzeria! Don’t forget to activate the furnace accelerator!

3. Mindfulness.

Not only accuracy and speed are important, but also attentiveness! Incorrectly placed or not reported ingredients can result in a refund! Read the recipe at the top of the screen more often!

4.Improvements.

Improvements for the pizzeria

Buy upgrades such as: Tables, Daylight Savings Time, Happy Days, Beginner Markup, Fast Oven, Hire an Animator, and more. Last but not least, buy “Hire an assistant for …”.

5. Use the Maypad.

Achievements

Use the Maypad to accept tasks and see what achievements you need to complete to get bonuses!

6. Well done pizza.

Well done pizza, dark crust pizza, or put in the oven twice, I need toasted or crunchy, these are all pizzas that need to be run through the oven twice.

7. How to cut a pizza.

If the customer said nothing about how to cut the pizza, then you need to cut it into 6 pieces! For example, “0 cuts” means not to cut and immediately after the oven into the box!

8. Pizza half and a half.

If a customer asks for a half and a half pizza, it means that the filling is only on one side, and the cheese and sauce for the whole pizza!

9.Sauce and cheese.

Sauce and cheese are always put in, unless the buy itself asks you to exclude something from it!

10. What?

Press “What” more often if you are not sure what to put in your pizza! There is even an achievement in the game associated with it!

Recipes.

Click FIND ON PAGE in your browser and enter the recipe!

Common recipes are formed like this:

All pizzas always have sauce and cheese!

Sauce + cheese + pepperoni = Pepperoni pizza

Sauce + cheese + sausages = Sausage Pizza

Sauce + cheese + mushrooms = Mushroom Pizza

And so on: Olive, Onion, Sweet pepper, Bacon, Pineapple, Anchovy, Ham, Basil …

More complex recipes from the Recipe Book below:

Meat pizzas

Classic meat – pepperoni and sausages

Meat lovers – pepperoni, sausages, bacon and ham

Without meat (there is not enough Corn in the picture)

The difference between Vegetarian and Vegan pizza is that there is no CHEESE in Vegan (vegans do not eat food of animal origin).And so we put all the vegetable that is except for eggplants: mushrooms, olives, onions, bell peppers, pineapples and basil.

All in a heap

Maxi – pepperoni, sausages, mushrooms, olives, onions, bell peppers.

Fruit Pig – pepperoni, sausages, olives, bell peppers, bacon, pineapple and ham.

Anchovies

Smelly pit – ansochus with onions

Salted sailor – anchovies with olives

Grass

Green Dream – Bell Peppers and Basil.

There are only three missing in my recipe book, I’ll add it as I open it!

What are buyers asking for?

Well, and the most interesting, in fact, the gameplay of the game – Good pizza, Great pizza – consists of the client’s requests and the collection of the pizzas themselves. Let’s analyze some clients with their incomprehensible wishes and our own recipes!

Yes … uh … mushrooms.

If the client does not explain anything plainly, but names an ingredient, it means: Sauce + Cheese + Ingredient.

Give me some truffle pizza.

Mushrooms are like truffles. Cheese + Sauce + Mushrooms.

Half meat, half vegetable pizza.

This means that we put sauce and cheese on the whole pizza, and all the meat we have on one side, and all herbal ingredients on the other.

I would like a turnip pizza.

Turnip is an Onion, as you can see from the word “onion”.

Can I have a vegetable pizza please?

Vegetarian.

Girl with eggplant

We say to the girl – YES!

Make me an eggplant pizza!

Sauce + Cheese + Eggplant

I heard that any cormorant wants pizza with this filling! Bake it for me, are you not in the first one?

Sauce + Cheese + Eggplant

HAHAHAHA !!! I’ll Pizza Joker!

Pepperoni, green pepper and eggplant

This is a superfood ultimate extreme pizza.

Maxi from recipes.

Ding-dong!

Bell pepper is like a bell. Sauce + Cheese + s.p.

Deluxe.

Maxi.

I’ll take a fully dressed pizza.

Everything you have from ingredients except eggplant.

Edgar Allan PO is our guest!

“Meat Lovers” from recipes for software.

Can I get two pizzas with … big purple tomato-like pieces?

Eggplant pizza.

Gris-Gris-Mushrooms pizzas.

Three mushroom pizzas.

I need an empty pizza.

Just a circle of dough.

Is it a crime to order without bell peppers and mushrooms? LOPS! Got it?

Onions, Olives, Pepperoni and Sausages.

One wombo combo!

Pepperoni, Sausages, Onions, Olives, Mushrooms and Peppers.

GOAL!

Mushrooms, Olives, Onions.

I want a mushperoni pizza.

Pepperoni and Mushrooms)))

I’ll take a spicy combo!

Olives and Onions.

Please give me a pizza with Nothing.

Just dough.

Wonderful pearls tears down to the seabed. She doesn’t want to, but she will have to return to the depths again. Yes, and could I get it cut in half.

Pizza with Anchovies)))

Dracula

All vegetables for Count Dracula, but no onions! Pizza composition: Sauce, Cheese and Basil.The Earl also appears in the Halloween event.

Give me a spicy cake.

Pepperoni and Pepper.

I want a pizza to help me lower my risk of heart disease, type 2 diabetes, obesity and some forms of cancer … with basil.

Pizza with basil)))

I’ll take a fully dressed pizza.

We put everything except the eggplant!

I want breakfast! But I can’t choose between pizza or bacon and eggs.

Bacon and Eggplant.

Hawaiian pizza.

Sauce, Cheese, Pineapples, Ham.

I want a couple of pescetarian pizzas without vegetables.

Cheese, Sauce, Olives, Pepper, Pineapples, Mushrooms, Shrimps and Anchovies.

Captain Sparrow

Salami + Pepperoni.

I am sharing with my cat. Two pieces.

One half with Olives and the other half with Anchovies.

Greetings. I am an artist. On my pizza, I would like to see a red tide splashing on the shores of the grassy coast.

Only Sauce on one side and Cheese and Basil on the other.

I just want to get some SP. for me. Two pieces. Can I get it baked well?

Pizza with Pepper.

Square root of Pi … one in the mind … Pythagoras could not imagine! It’s a mathematical perfect pizza!

Young mathematician

First half: Sauce, Cheese, Olives, Anchovies

Second half: Sauce, Cheese, Pepperoni, Sausages, Olives, Pineapples, Ham, Bacon

All visits of the boy are described in a separate article, it is available at THIS LINK.

I want a fruit pizza.

The fruits in the game are: Olives, Bell peppers and Pineapples.

I have to write an essay on Hamlet, so I’m here for research.

Hamlet in English – Ham let, and ham Ham. That is pizza with ham!

Did you know that 98% of known fish spawn?

Anchovies + Eggplant. Perhaps the developers of the eggplant rings resembled eggs)))

The filling I want could be a wonderful home for a sea sponge.Cut it in half twice.

Pizza for SpongeBob with Pineapples!

I want a couple of pescatarian pizzas without vegetables.

Sauce, Cheese, Olives, Pepper, Pineapples, Mushrooms, Anchovies.

I am sharing a pizza with my cat. Dark crust.

Sauce, Cheese, Olives on one side, Anchovies on the other. Twice in the oven.

My sister is vegetarian, but she also loves vegetables and fruits.She loves mushrooms however … not on pizza.

Sauce and Cheese.

Three pizzas and I want you to make them grainy!

Three pizzas with Corn.

I’ve tried corn in soup, in bread, on the cob … and on pizza?

With Corn.

I want a pizza topped with fruit. Including sea fruits!

Sauce, Cheese, Olives, Bell Peppers, Pineapples, Shrimps.

Which came first, the chicken or the tank … lazhan?

Sauce, Cheese, Eggplant, Chicken.

Wheat with everything; without meat.

Everything you have, except meat, eggplants can be skipped.

Forget the haters, pineapple and corn belong to pizza! But maybe not at the same time … Yes, and make it well baked.

Sauce, Cheese, on one side Pineapples, on the other Corn.

I’ll be BORED, please!

Sauce, Cheese, Corn.

Half cheeseless pepperoni, half sauceless chicken pizza to deserve my favor.

One side is salami and sauce, the other is cheese and chicken.

I’m crazy about chicken! Three de pollo pizzas, now a favorite!

Sauce, Cheese, Chicken.

Chicken Parmesan is great, but mozzarella is also perfectly acceptable.

Sauce, Cheese, Chicken.

I want a pizza with everything you have.

All that you have, the eggplants can be skipped.

Hey, do you make shrimp kebabs? If not, then put all of their ingredients on top of the pizza.

Sauce, Cheese, Onions, Mushrooms, Shrimps.

I’ll be anything tropical.

Sauce, Cheese, Pineapples.

There are a million ways to cook them.Grilled, boiled, baked, fried, pan-fried, deep-fried, deep-fried …

A reference to Forest Gump))) With shrimps!

I can finally order a pizza with chicken Caesar salad! Make it very crispy.

Cheese, Basil, Anchovies, and Chicken.

Winning Champion, Chicken Dinner!

Sauce, Cheese, Chicken.

I want breakfast! But I can’t choose between pizza or bacon and eggs …

Sauce, Cheese, Bacon, Eggplant.

and then I need a shrimp cocktail and bread for the party. But … what if you combine them?

Sauce, Cheese, Shrimps.

I want to see chicken on my pizza. And what she eats!

Sauce, Cheese, Chicken, Corn.

I’ll have a gambery pizza with bell peppers and basil, please.

Sauce, Cheese, Bell Pepper, Basil, Shrimps.

No pain, no grain.

Everything you have except Corn. Eggplants can be skipped.

People love Hawaiian pizza, but real Hawaiian pizza is made with shrimp.

Sauce, Cheese, Pineapples, Shrimps.

Hawaiian pizza.

Sauce, Cheese, Pineapples, Ham.

This place looks like my favorite place at home! But can you make meat pizza just like at home?

Sauce, Cheese, Pepperoni, Sausages, Ham, Bacon

Can I have a big pizza.

Sauce, Cheese, Pepperoni, Sausages, Mushrooms, Olives, Onions, Sweet peppers.

I have two crayfish pizzas, please!

Sauce, Cheese, Shrimps.

Let’s check how well you know pizza recipes. Make me a Flamkuchen.

Cheese, Bacon, Onion.

I’ve lived in France for years. Let’s see how your Pissaladeri presents its roots.

Onions, Olives, Anchovies.No Sauce and Cheese.

Pizza Margarita.

Cheese, Sauce, Basil.

I have heard that for eggplants to be delicious you need to put cheese and marinara on them, but not vice versa.

Sauce, Cheese, Eggplant.

Pizza Marinara.

Sauce.

All orders of this girl and their recipes can be found in the article on THIS LINK!

Pizza with Invisible Fillings is linked to the Show Me Your Face achievement, there is a separate article for it on THIS LINK!

All orders of the girl with a camera in a red cap are associated with the achievement Pizzlewicz and are described in the article on THIS LINK!

To find out my order you must solve this formula: E = mc2.

Two Cheese and Mushroom pizzas for Einstein, WITHOUT SAUCE!

I want a pizza with everything in my garden.

Sauce, Cheese, Olives, Onion, Pepper, Basil.

I want a field of fish.

Anchovies, nothing else.

I want pizza, but don’t put animals, vegetables or minerals in there.

Sauce, Cheese, mushrooms.

Do you want to hear a pizza joke?

Sauce, Cheese.

I wanted an omelette with flavors, but since this is a pizzeria, I’ll take a pizza for breakfast.

Sauce, Cheese, Sausages, Mushrooms, Onions, Ham and Bacon.

I want pizza. I want you to spread the sauce on it, sprinkle it with cheese, bake it, make it smell and send it to the farm to play with bacon.

Sauce, Cheese, Bacon, Onion

Wonderful pearls tear down to the seabed. She doesn’t want to, but she will have to return to the depths again.

Sauce, Cheese, Anchovies.

I want a pork pizza. Don’t bother yourself with sauce or cheese or fish. Also, don’t cut the pizza, please.

Pepperoni, Sausages, Ham, Bacon.

I need food drags, champion.

Only dough.

Do you know what ratatouille is? I want it, but on pizza!

Sauce, Cheese, Onion, Pepper, Basil and Eggplant.

I want breakfast! But I can’t choose between pizza or bacon and eggs …

Sauce, Cheese, Bacon, Eggplant.

PAP, please.

Sauce, Cheese, Pepperoni, Pepper, Pineapples.

I’ll take some sweet and savory pineapples and olives, please.

Sauce, Cheese, Pineapples, Olives.

I want mushperoni pizza.

Sauce, Cheese, Pepperoni, Mushrooms.

I need a shrimp cocktail and bread for the party. But … what if you combine them?

Sauce and Shrimps.

Chicken grain by grain.

Everything you have from fillings, except for eggplant and CORN!

Pizza Macaroni.

Sauce, Cheese, Pepperoni.

Can I order two carbonara pizzas with eggplant instead of eggs?

Sauce, Cheese, Onion, Bacon and Eggplant.

Can you feel it? This smell. Some smelly smell. A smelly smell that smells smelly.

Sauce, Cheese, Anchovies.

Bacon in the eye of the beholder. And I want to see it.

Sauce, Cheese, Bacon.

I want something tropical.

Sauce, Cheese, Pineapples.

I’m going to the bad breath competition.

Sauce, Cheese, Onions, Anchovies.

Can I get a Hot Dog?

No. We don’t have hot dogs in our pizzeria

Woof Woof! (What am I doing here?)

The dog will just appear and disappear, and you will receive the achievement: Woof Woof! See the dog.

Suspicious persons!

Often in Good pizza, Excellent pizza there are suspicious people, let’s deal with two of these:

Thief

This kid is a thief! We press “What” or “No” for all his questions! Otherwise, he will rob you and you will lose money from the cash desk!

Have fun with this Pizza Baking Oven? Give me pizza with toppings up to the sky.

This is also a thief’s order, and you don’t have to do it, but if you still took such an order, you can just throw one dough!

Aspiring businessman

This homeless person has huge plans for the future, help him with money (a couple of times) and you will be pleasantly surprised at high levels! But be careful, I do not know how the game is provided, but my level ended in a minus and I was bankrupt, I had to replay the level! Perhaps it appears when you have enough money to complete the level with a plus!

Celebrities.

Also at our Good pizza, Great pizza is often visited by celebrities, I have not yet fully assembled their entire wall, but I have something:

Celebrity collection

Here I have Captain Sparrow, Edgar PO, Allan Musk, Elvis and Marilyn Monroe, only two are missing! One of them is Mozart, and the second is some mathematician)))

Sauce-Viewer Trials at the link below!

But I know why you are here! Behind the Saucers Challenges in Good Pizza, Great Pizza! And I went through all of them and I hasten to share them on Gadgetpley, go to THIS LINK.

Dr. Keh with accusations!

PizzaCon will also take place in the game, its passage can be found at THIS LINK.

Passage of the event Monstrous kneading, which is dedicated to Halloween, you can look at THIS LINK.

Recipes. Chapter 4.

The main article with the passage of 4 chapters is available at the link above!

Green pesto and red tomatoes taste insanely great!

Green Sauce, Cheese and Sliced ​​Tomatoes.

Some people don’t like the smell of fried mushrooms or garlic. I think they look great together! Oh, and could you use pesto sauce?

Green Sauce, Cheese, Mushrooms and Garlic.

One thin pizza, please. Also, make it dark.

Just dough, and pass it through the oven twice (I don’t).

Can I order bianco pizza?

Sauce, Cheese, Garlic and Basil.

Hey guys, do you make whole wheat garlic bread? I just want a little of this, thanks!

Second dough and Garlic – that’s it!

Cheese garlic bread – my favorite! Are you guys doing this here? Cut it in half twice.

Only Cheese and Garlic on the dough!

I felt people were judging me when I went to the BPD just to order a cake.

Just dough.

I’d like three pizzas, please! One for me and two for my car.

Any pizza, I just threw in three cakes.

Oh, I’ll be bruschetti with pesto!

Green Sauce, Cheese, Basil, Garlic and Chopped Tomatoes.

I love going to different pizzerias to see what their specialties are!

Your Branded Pizza.

Try saying it 3 times quickly: nothing beats a slice of pepper pizza!

Bell peppers and Jalapenos need to be put in!

I’m hungry that I could eat two firms!

Your Branded Pizza.

Over time, I will replenish the article with new recipes, you can also write recipes in the comments! Thanks!

Tomato or tomato. Whatever, just put it on my cheese pizza.

Sauce, Cheese and Sliced ​​Tomatoes.

I want to start a jalapeno business.

Sauce, Cheese and Jalapenos.

I’m a little hot chili. Can you give me something hot to keep me warm? Oh, and could you use the pesto sauce.

Pesto Sauce, Cheese and Jalapenos.

Ever tried jalapeno poppers wrapped in bacon? They are so good! I would like you guys to do that.

Cheese, Sauce, Bacon and Jalapeno.

Try saying 3 times quickly: nothing beats a slice of pepper pizza!

Sauce, Cheese, Bell Peppers and Jalapenos.

Give me a pizza that I love from head to toe.Understood?

Cheese, Sauce, Olives and Sliced ​​Tomatoes.

Help, there is a vampire trying to suck my blood!

Cheese, Sauce and Garlic.

I’ll have one Hawaiian jalapeno pizza, please!

Cheese, Sauce, Ham, Pineapples and Jalapenos.

90,000 Why is milk good for you? – “Food”

Fat

There are many attacks on milk fat today
by people who pursue their own goals, including marketing –
promoting non-dairy fats.But as a hygienist I would like to say that
milk fat is very necessary for the human body.

Yes, any fat, including milk fat, is
the most high-calorie nutrient. But if we are not talking about high-fat cream or
sour cream, and about milk, then normalized milk contains from 3 to 3.5
percent fat. This is probably still not the amount for which you need
breaking spears.

Milk fat is important not only for its energy
value, but also what it contains quickly
digestible medium-chain fatty acids such as nylon, caprylic,
capric.It is due to this property of their medium-chain acids, which
isolated during fractionation of milk fat, used as additives –
enrich them, for example, sports nutrition, that is, the nutrition of people who
spend a lot of energy and need to replenish it quickly. Medium chain
fatty acids are easily absorbed by those people who have inflammatory
or other bowel problems. They are also added to infant formula for
artificial nutrition for children. It is very valuable from a biological point of view.
component.

In addition, milk fat contains so
called lipoids, fat-like substances that help improve
fat metabolism in the human body. First of all, these are lecithins,
fat emulsifiers – they are contained in the shells of milk fat globules. Lecithins
not only participate in fat metabolism, they are also precursors
components of the myelin sheaths of the nerve trunks, that is, they are included in the composition
nervous tissue. And it is believed that lecithins contribute to normal
the functioning of the nervous system.When butter and fat shells are beaten
balls are destroyed, lecithin turns into buttermilk. We don’t have a lot of products
from buttermilk, and I think that you need to pay attention to it, especially since buttermilk
not as high in calories as whole milk products.

Milk also contains such a lipoid
factor like ergosterol, one of the fat-like substances that are involved in cholesterol
exchange. It contributes to the normal elimination of cholesterol from the body and, besides
Moreover, it is a precursor of vitamin D.So drink milk with the proper
his fat content is very useful.

But if a person is forced due to different
causes, including obesity or other diseases associated with a violation
lipid metabolism, limit fat intake – please,
the consumer market presents many dairy products with reduced
fat content. Moreover, I consider it harmful to attack foods in which fat
milk fraction is completely or partially replaced by milk fat substitute for
based on vegetable oils.Because milk fat substitute is not easy
some vegetable oil unknown
origin, and a product that is specially developed taking into account
the need to replenish certain micronutrients of milk, that is, it is enriched
vitamins, mineral elements, as well as polyunsaturated fatty
acids. So it makes sense for seniors and obese people
choose just similar products.

90,000 symptoms, treatment, is it possible to get rid of forever, how to treat IBS, diet and nutrition

In April 2019, I had a severe stomach ache.The pills did not help, and a day later the ambulance took me to the hospital.

Sergey Belonozhkin

treated pancreatitis and cured IBS

Author’s profile

There were only two symptoms: constant acute abdominal pain and diarrhea. During the first week in the hospital, I lost 6 kg and began to weigh 54 kg with a height of 172 cm. After that I managed to go to a private clinic, try several diets and lie down in another public hospital. In the end, I was finally diagnosed with irritable bowel syndrome.

Irritable Bowel Syndrome – IBS is a disorder of the gastrointestinal tract that is accompanied by pain in the abdomen, usually below the navel. IBS can also have diarrhea, constipation, false urge to use the toilet, and bloating. Patients often lose weight due to severe diarrhea.

Clinical manifestations of irritable bowel syndrome in adults – Uptodate

Irritable bowel syndrome impairs quality of life and often forces a person to reconsider diet and habits.For example, in America, IBS is the second most popular reason why people do not go to work. In the first place is the common cold.

See a doctor

Our articles are written with love for evidence-based medicine. We refer to reputable sources and go for comments from reputable doctors. But remember: the responsibility for your health lies with you and your doctor. We do not write prescriptions, we make recommendations. It is up to you to rely on our point of view or not.

Reasons

The exact cause of irritable bowel syndrome is unknown. Scientists only know about the factors that contribute to the development of the disease.

Irritable Bowel Syndrome – Mayo Clinic

Incorrect functioning of the intestinal muscles. In the walls of the intestine are muscles that push food. Sometimes they can contract too hard or not relax for a long time. This leads to gas formation, discomfort, abdominal pain and diarrhea.If the muscles, on the contrary, contract too weakly, food is retained inside the intestines, which leads to constipation.

Disorders in the nervous system of the gastrointestinal tract. In IBS patients, the nerves that control bowel function may overreact to normal stimuli. This causes muscle contraction, which causes pain and discomfort. For example, if a healthy person can safely drink carbonated drinks, then in some people with IBS, they will exacerbate the disease.Food is not necessarily an irritant; abdominal pain and discomfort can arise from stress, for example.

Consequences of intestinal infection. IBS can occur after food poisoning or specific intestinal infections: salmonellosis, cholera, typhoid fever.

Severe stress. People who have experienced severe shock, especially in childhood, are more likely to develop IBS.

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Symptoms and Diagnosis of IBS

Irritable bowel syndrome is difficult to diagnose: diagnosis is made only when all other possible causes of abdominal pain have been ruled out.IBS can be predicted by the following symptoms.

Abdominal pain or discomfort. The pain is usually below the navel, but sometimes the pain is felt in other parts of the abdomen or has no localization at all. The pain can be sharp or aching, constant or arising only in response to certain types of food.

Intestinal symptoms. These include diarrhea, constipation, false urge to use the toilet and bloating.

The abdomen with IBS usually hurts below the navel, but there are exceptions

To confirm the diagnosis, the doctor may prescribe additional examinations: ultrasound of the abdominal cavity, stool analysis, celiac disease test, colonoscopy.They are needed to exclude other diseases: celiac disease, Crohn’s disease, tumors of the gastrointestinal tract, pancreatitis, appendicitis.

Doctors also pay attention to “red flags” – symptoms that are rare in IBS and most likely indicate some other, more serious illness:

  1. blood in the stool;
  2. diarrhea at night;
  3. sudden weight loss;
  4. repeated unnecessary vomiting;
  5. Difficulty swallowing food;
  6. persistent abdominal pain that is not accompanied by bloating, diarrhea, or constipation.

If you have any of these symptoms, you need additional advice from a physician or gastroenterologist.

Treatment of IBS

I will discuss the main areas of treatment for irritable bowel syndrome.

Diet. For IBS, a diet with the exclusion of FODMAP foods is recommended. These foods contain gluten, lactose, fructose and substances that contribute to gas formation. For example, with such a diet, you should not eat garlic, onions, apples, peaches, bananas, sausages, almost all baked goods, honey, dairy products and alcohol.A diet that eliminates FODMAPs can help relieve pain and intestinal symptoms such as bloating, diarrhea, and constipation.

Once the intestines have calmed down, new foods can be introduced into the food, one per week. If digestive problems return, the patient will know what food to avoid.

During the flare-up period, I switched to gluten-free sweets and snacks. This is a good alternative to regular biscuits or crispbreads, only expensive

Finding and eliminating irritants. In IBS, it is important to exclude foods and events that exacerbate the symptoms of the disease. To do this, you can keep a diary and record the body’s response to physical activity, different foods, a change of environment. This will help you find out what exactly is causing the exacerbation of the disease in order to avoid it in the future.

I did not keep a diary, but noted to myself what exactly caused the aggravation.

Example of a food diary: in a commentary, you can record the body’s reaction to food

Psychosocial therapy. If the illness is exacerbated by stress, your doctor may recommend seeing a psychotherapist or psychiatrist. This is a normal practice to learn how to respond more easily to stimuli. At this stage, the psychiatrist may prescribe a course of antidepressants.

Physical activity. Moderate exercise can help reduce symptoms of IBS. These are walking, stretching, house cleaning, cycling, team games. In an American study, people who performed 20-60 minutes of physical activity three to five times a week were less likely to experience diarrhea with IBS.

Physical Activity and IBS Symptoms – American Journal of Gastroenterology

Medicines. There is no single drug for the treatment of IBS. Doctors evaluate each patient’s symptoms and prescribe medications to help manage them.

For the treatment of IBS, the following groups of drugs can be used:

  1. Antispasmodics to relax intestinal muscles and relieve pain.
  2. Antidiarrheal to relieve diarrhea.
  3. Laxatives to relieve constipation.
  4. Defoamers and chelators to get rid of bloating.
  5. Antibiotics to reduce symptoms of IBS with diarrhea predominant.
  6. Probiotics to restore the intestinal microflora.
  7. Antidepressants for patients with depression or in cases where antispasmodics and antidiarrheals do not help relieve pain.

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How I treated IBS

My digestive problems started at university, 17 years ago. Then gastroenterologists diagnosed me with gastric ulcer. The ulcer was cured, but the problems remained: in the morning, the stomach often ached, there was bloating or diarrhea. I used to live like this and did not go to the doctors.

In April 2019, my stomach pain was so bad that I called an ambulance.The ambulance doctors suggested an inflammation of the pancreas – pancreatitis – and took him to the emergency hospital. After examination, the surgeon confirmed the diagnosis and admitted me to the hospital.

Upon admission, I underwent an X-ray of the abdominal cavity, took blood and urine for analysis. I did not take a stool test, although its results appeared from somewhere in the discharge report.

In the ward, they gave me an injection of an antispasmodic and put on a drip with an anesthetic. The pain went away quickly, and the diarrhea disappeared with it. In the evening of the same day, I underwent FGDS and ultrasound of the abdominal organs – the doctors did not find anything critical.

Based on the results of the examination, I was prescribed a diet “table number 5” and was recommended to be observed by a therapist at the place of residence.

In the canteen, they did not feed me according to the principle of the prescribed diet, but simply gave what was. Therefore, I asked my wife to bring food on a diet. A week later I was discharged home, and the next day my stomach ached again and diarrhea appeared.

I think the relapse was due to the disappearance of the injections and IVs. This is not surprising, because I was not treated for IBS.

How I got the SRK

After a relapse, I had to urgently go to a therapist in a polyclinic.He referred me to a gastroenterologist, but it took a week to wait.

I decided not to wait and went to a gastroenterologist at a private clinic. He chose the doctor himself according to the reviews on the portal about doctors.

The gastroenterologist immediately suggested IBS. To confirm the disease, he prescribed a diet excluding FODMAP foods and several tests:

  1. Celiac disease test. It is a disease in which the body cannot metabolize gluten. Celiac disease is similar in symptoms to IBS.
  2. Tests to rule out inflammatory bowel diseases: ulcerative colitis and Crohn’s disease.
  3. General analysis of feces.

For the tests, I paid 3406 R. A doctor’s consultation cost another 815 rubles.

This visit gave me more than a week in the hospital: I ruled out FODMAP foods, started taking an antibiotic and an antispasmodic. Paid for medicines 1300 R.

10 606 R

I spent on the treatment of IBS

I felt much better, my digestion was almost normalized: my stomach ached only from time to time after eating. I began to buy sweets only gluten-free – it hit my pocket.These cookies are, on average, five to six times more expensive than regular cookies.

How I lay in gastroenterology

I was frightened by the weight of 54 kg, so I decided to go to the regional hospital. There they put me in gastroenterology.

In the second hospital, the approach was much stricter – blood and feces were taken several times during the week. I was prescribed saline, antispasmodic, vitamins, antibiotic, sedative, and enzymes to improve digestion.

The hospital turned out to be much neater than the previous one.New building, clean rooms, few people. And most importantly, they fed in accordance with my diet. In the dining room, you had to say the diet number in order to get the first, second and boiling water for tea. If not full, they gave supplements without any questions. The food was delicious: breaking the horrible hospital food template.

My room has four seats. There was only one person with me – he was examined for the operation. Women’s wards were filled to capacity

I am not a culinary specialist and I cannot say what exactly they fed. The diet definitely included low-fat soups and steamed cutlets

Here are the examinations I went through:

  1. Ultrasound of the abdominal organs.
  2. FGDS and sigmoidoscopy.
  3. Tests for celiac disease.
  4. Analysis of feces for carbohydrate content.

A consultation with a geneticist was also scheduled. He found partial lactose intolerance: stool analysis showed an increased carbohydrate content.

By the end of the week in the hospital, my stomach stopped hurting. I had to eat strictly according to the diet, but it was justified. I lived and ate on schedule, except that the weight was in place. But I was calm: at least he stopped falling.

The tests prescribed by the geneticist cost 2640 R. So we once again ruled out celiac disease and found problems with lactose tolerance. Now my stomach hurts much less often, as I avoid dairy products

What has changed since discharge

When I was discharged, I was prescribed a sedative “Prosulpin” and was advised to worry less. Up to a change of place of work, if there is a lot of nervousness. They also strictly limited physical activity – I had to stop playing sports, I left only exercises in the morning.

Another doctor said that you can go to a psychologist to work on self-control in stressful situations. It is difficult to solve such problems on my own, but I did not register with a specialist. I tried to understand myself and change my approach to stimuli. For example, I began to behave more calmly while driving: I do not freak out if someone cut off on the road. I choose calm music for the car, like jazz. Now I can even convince myself that when people are rude to me, this is not a personal attitude, but the result of their life problems.Therefore, you need to treat them more calmly.

Two months after discharge, I began to add one new product to the diet every few days and watch the body’s reaction. So I walked away from a gluten-free diet, but I still can’t eat some dairy products. For example, I calmly tolerate cheese and low-fat cottage cheese, but kefir and ice cream cause an exacerbation of the disease.

Now every morning I start with exercises and oatmeal in the water. Earlier in the morning I could not bring myself to eat at least something, and the first meal was at lunchtime.

I eat freely: I can eat burgers, pizza, cutlets, fries. I’m not returning to a gluten-free diet: the intestines react normally to common sweets and pastries. I only avoid dairy products, beans, corn, and dried apricot or prune pies. If I eat, I instantly feel the urge to go to the toilet.

I hardly need any medication. Once every six months or less, I repeat the sedative course on the recommendation of the doctor. The weight returned to the 62 kg mark and remains unchanged.

How much did I spend on treatment

For all the time I have spent money on tests, medications and consultation with a gastroenterologist. General blood and stool tests and most of the drugs in hospitals were free. I had to spend only on some tests and drugs.

How much money did it take to cure an exacerbation of IBS

Blood test for immunoglobulins

2200 R

Inflammatory Bowel Disease Test

1780 R

Analysis for celiac disease

1092 R

Alpha Normix

830 R

Appointment with a gastroenterologist

815 R

“Moviprep” for preparation for FGDS

720 R

“Probiologist” 180 mg

563 R

Neobutin 300 mg (trimebutin)

470 R

“Kolofort”

444 R

Analysis for celiac disease

440 R

General analysis of feces

424 R

Prosulpin 50 mg, 3 packs

291 R

“Mezim Forte” 10,000

180 R

Blood sampling from a vein

110 R

“Pancreatin” (instead of “Mezim”)

46 R

Total spent on tests and medications

10 606 R

Remember

  1. IBS is an intestinal disorder that is accompanied by abdominal pain, bloating, constipation, or diarrhea.
  2. Irritable bowel syndrome is only diagnosed if other causes of abdominal pain have been ruled out.
  3. Treat IBS with diet, elimination of irritants, work with stress. Medication is only prescribed to relieve symptoms.
  4. For IBS, a diet with the elimination of FODMAP foods is recommended, according to which you will have to switch to foods free of gluten, lactose and fructose. This will make cooking difficult, and gluten-free sweets will hit your pocket.
  5. For many people, stress makes IBS worse.Therefore, the doctor may recommend changing jobs, avoiding stressful situations, or signing up for a psychotherapist.

Have you also had an illness that affected your lifestyle or attitude? Share your story.

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