Saturday, March 27, 2010

Lactose Intolerance after Gastric Bypass

It is very common after RNY surgery for people to suddenly become lactose intolerance. My sister had RNY 8 years ago - she's lactose intolerant.  My mom had RNY 6 years ago - she's lactose intolerant. So when I had my RNY 2 years ago I fully expected to also be lactose intolerant.  In fact, for the first 4 months after my surgery I was too scared to drink normal milk so I would only use soy milk. But somehow I got lucky and milk and I are friends.

I'm definitely the minority though among the WLS community. Plus, I found out that I already had a second strike against me - my Native American heritage.  So I definitely got lucky in the lactose department. I'd miss my milk for sure.

So you know how I am, right?  I like to know WHY stuff happens.  I was excited when I found this info. I recently stumbled across some information about lactose intolerance that explains to me why the intolerance is so common after RNY.  It has to do with the enzyme that processes milk in our digestive tract and the fact that it's production center is now bypassed. And we know that the first part of the small intestine (first 4 to 5 feet) is bypassed and any enzymes produced in that portion doesn't mix with food until further down in the digestive tract.  So by the time the milk and enzyme mix, the intolerance symptoms have already begun.  Let's let Dr. Joyce explain it:

Lactose intolerance is the inability to digest significant amounts of lactose, the predominant sugar of milk. This inability results from a shortage of the enzyme lactase, which is normally produced by the cells that line the small intestine.  Lactase breaks down milk sugar into simpler forms that can then be absorbed into the bloodstream. When there is not enough lactase to digest the amount of lactose consumed, the results, although not usually dangerous, may be very distressing. Common symptoms include nausea, cramps, bloating, gas, and diarrhea, which begin about 30 minutes to 2 hours after eating or drinking foods containing lactose. 
Some causes of lactose intolerance are well known. For instance, certain digestive diseases and injuries to the small intestine can reduce the amount of enzymes produced.  Between 30 and 50 million Americans are lactose intolerant. Certain ethnic and racial populations are more widely affected than others. As many as 75 percent of all African-Americans and Native Americans and 90 percent of Asian-Americans are lactose intolerant. The condition is least common among persons of northern European descent.

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