Lactose Intolerance (cont.)
Milk challenge
A milk challenge is a simpler way of diagnosing lactose
intolerance than an elimination diet. A person fasts overnight and then drinks a
glass of milk in the morning. Nothing further is eaten or drunk for 3-5 hours.
If a person is lactose intolerant, the milk should produce symptoms within
several hours of ingestion. If there are no symptoms, it is unlikely that
lactose intolerance is the cause of the symptoms. It is important for the milk
that is used to be non-fat milk to eliminate the possibility that fat in the
milk is the cause of symptoms. It is not possible to eliminate the possibility
that symptoms are due to milk allergy, a very different condition than lactose intolerance; however,
this is not usually confusing since allergy to milk is rare and usually occurs
in infants and young children. (If milk allergy is a consideration, pure lactose
can be used instead of milk.)
An important issue in the milk challenge is the amount of milk to use.
- If a person drinks glasses of milk or ingests larger amounts of
milk-containing products in their normal diet, then a larger amount of milk
should be used in the challenge, 8-16 ounces in an adult, equivalent to one or
two large glasses of milk.
- If the person being tested usually does not drink glasses of milk or
ingest larger quantities of milk-containing products, there may be a problem
with using 8-16 ounces of milk for testing. These larger quantities of milk used
for testing may cause symptoms, but the smaller amounts of milk or milk products
that these persons ingest in their normal diet may not be enough to cause
symptoms. Technically, they may be lactose intolerant when they are tested with
larger amounts of milk, but lactose in their normal diet cannot be responsible
for their usual symptoms.
Recognition of this issue is important in interpreting the results of a milk
challenge.
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