Lactose intolerance diagnosis

Lactose Lactase, fl-galactosidase Milk Products destined to lactose intolerant persons Cow and milk diagnosis... 

As this patient s history indicated that his problems began soon after he started taking 2 cups of milk with lunch at school and his physical examination and stool examination findings suggested he had carbohydrate malabsorption, a diagnosis of lactose intolerance was made. It was recommended that his milk intake at lunch be decreased to half a cup (about 4 oz). His symptoms improved considerably and almost immediately. His milk intake was then gradually increased such that he was ultimately able to take up to 8 oz of milk without much complaint, especially when the milk was taken with other foods. 

The diagnosis of lactose intolerance should be strongly suspected ahead of any of these other differential diagnoses when a patient presents with the characteristic symptoms enunciated above following ingestion of lactose-containing drinks or foods such as milk, particularly if the patient belongs to an at-risk population. 

FIGURE 36-2. Recommendations for treating chronic diarrhea. Follow these steps (1) Perform a careful history and physical examination. (2) The possible causes of chronic diarrhea are many. These can be classified into intestinal infections (bacterial or protozoal), inflammatory disease (Crohn s disease or ulcerative colitis), malabsorption (lactose intolerance), secretory hormonal tumor (intestinal carcinoid tumor or VIPoma), drug (antacid), factitious (laxative abuse), or motility disturbance (diabetes mellitus, irritable bowel syndrome, or hyperthyroidism). (3) If the diagnosis is uncertain, selected appropriate diagnostic studies should be ordered. (4) Once diagnosed, treatment is planned for the underlying cause with symptomatic antidiarrheal therapy. (5) If no specific cause can be identified, symptomatic therapy is prescribed. 

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