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No milk today

BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7313.640 (Published 15 September 2001) Cite this as: BMJ 2001;323:640
  1. M D Harris, consultant histopathologist
  1. Huntingdon

    Although I am not a gastroenterologist, I feel that I am well qualified to write on this topic. My “gut rot” really started around seven years ago, in my mid-30s. I had been diagnosed as having irritable bowel syndrome as a student, but this was something more. The symptoms became quite distressing and, after a negative colonoscopy, a simple test revealed that I was lactose intolerant.

    In other mammals, milk would be present in the diet only while they were breast fed

    The milk sugar lactose is a disaccharide found naturally only in milk products. In non-sufferers it is split in the small intestine by lactase into glucose and galactose, which are readily absorbed. In the absence of endogenous lactase enzyme, the sugar passes into the large bowel, where it is broken down by lactobacilli, part of the normal flora. The products of this digestion include hydrogen, some of which is absorbed and excreted via the lungs, the remainder leaving by an alternative route. The raised level of hydrogen in …

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