Lactose Intolerance in Celiac Patients

Lactose intolerance is the inability or insufficient ability to digest lactose, a sugar found in milk and milk products. Lactose intolerance is a result of a shortage of an enzyme called lactase. Lactase is produced in the cells that line the mucosa, or inner surface, of the small intestine.  Lactase breaks down lactose into two simpler forms of sugar called glucose and galactose, which are then absorbed into the bloodstream.

People with lactose intolerance may feel uncomfortable after consuming milk and milk products. Symptoms can include abdominal pain, abdominal bloating, gas, diarrhea, and nausea. Normally, the body uses lactase to digest lactose in the small intestine, so it can then be absorbed into the bloodstream.

Lactose intolerance is very common in people with celiac disease, but lactose intolerance in celiac disease often improves after patients have been on a gluten-free diet for a while. Untreated celiac disease (that is, disease not being treated with the gluten-free diet) produces a chronic inflammation of the small intestine mucosa, injuring the cells that ordinarily produce lactase. Several studies have shown that untreated celiac patients have high rates of lactose intolerance. As their intestines heal on the gluten-free diet, however, their lactase-producing cells begin to function again and their tolerance for lactose-containing foods improves. In some cases the villi and microvilli damage can take up to two years to heal completely, but in most cases it takes between six months and a year.

Getting enough calcium and vitamin D is a concern for people with lactose intolerance when the intake of milk and milk products is limited. When I was first diagnosed with gluten intolerance, I was also diagnosed for dairy intolerance. Many foods can provide the calcium and other nutrients the body needs. Luckily, manufacturers are getting smart. Now there are many products on the market that are both gluten free AND dairy free.

Here is a wonderful homemade bread recipe that I adapted from a magazine called Living Without. I highly recommend subscribing to it if you are interested in a gluten free lifestyle. Like my weekly articles, it is full of wonderful recipes, tips and shopping guides for a gluten free lifestyle.

Sandwich Bread Recipe using King Arthur’s Flour Blend

Adapted from a recipe from Living Without Magazine

4 cups King Arthurs’ Gluten Free Flour blend ( Rice flour, tapioca flour, potato starch, whole grain brown rice flour)
1 tablespoon xanthan gum
1 tablespoon egg replacer
2 teaspoons salt
½ cup powdered milk
1 package (2¼ teaspoons) active dry yeast
3 large eggs
¼ cup butter
2 teaspoons cider vinegar
⅓ cup agave nectar
2 cups warm water (110 to 115 degrees)

Make sure all ingredients are at room temperature.
Grease two, 8-inch bread pans with olive oil.
Mix dry ingredients together in a medium-size bowl. Set aside.
Place eggs, butter, vinegar, honey and water in the mixing bowl of a stand mixer. With the paddle attachment, mix ingredients together for about 30 seconds.
Add the dry ingredients to the wet mixture.
Turn the mixer to medium-high speed and beat for 4 minutes.
Spoon the dough into prepared pans. Set aside in a warm place to rise, about 50 to 60 minutes. While dough rises, preheat oven to 375 degrees.
Place pans in the oven and bake for 50 to 60 minutes or until bread’s internal temperature reaches 200 degrees with an instant-read thermometer.
Let bread cool in pans for 10 minutes. Then remove loaves from pans and place on a rack to cool.

About Lisa Velick

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