Temporary Lactose Intolerance - It Can Happen to You

There are three types of lactose intolerance.

Congenital lactose intolerance is extremely rare. It occurs in a very few babies who can't make lactase at all. If they aren't put on a dairy-free formula immediately, they starve to death.

Primary lactose intolerance is also called, imprecisely, adult-onset lactose intolerance. In reality it can occur any time after the age of weaning. The ability to make lactase decreases or disappears and the symptoms of lactose intolerance strike.

But there is also secondary lactose intolerance, sometimes called temporary lactose intolerance. It occurs whenever there is damage to the intestines that knocks out - temporarily or permanently - the ability to manufacture lactase. Many conditions, from surgery on the intestines, to diseases, to drugs, to long-term abuse of the system can cause it. Whether the ability to manufacture lactase comes back depends entirely on the original cause of the damage and how well the intestines heal.

I mention temporary lactose intolerance now because there's a celebrity case of it in the news.



Golfer Trevor Immelman is back to full health after losing 22 pounds in a few weeks to a parasite.

The South African lost 22 pounds after it was diagnosed he had picked up a parasite which severely affected him for three weeks, but having regained his health, Immelman found himself in fine fettle again as he posted a solid four-under-par 68 to lead the South African challenge at Quail Hollow.

The 27-year-old described how he picked up a debilitating bug a month ago, just two days before the start of the Masters.

"I started feeling really ill. I pretty much slept in the restroom. My stomach felt like it was moving around inside me," Immelman recalled.

The cure? Antibiotics, of course. And his doctor also put him on a lactose-free diet.

Why? Two possible reasons. Without knowing more about the parasite or its effects, it might be that the bug affected the intestines and the extremely delicate and sensitive lactase-making villi, tiny projections on the insides of the intestines.

And antibiotics themselves are designed to kill bacteria. It's hard to discriminate among bad bacteria and good bacteria, so the "good" bacteria that live in the large intestine and digest any lactose that comes their way also get killed when a person takes a course of antibiotics. That means that the symptoms of undigested lactose often occur. The last time I took a course of antibiotics, it was a horrible week of roiling intestines and spasming diarrhea.

Oddly, the answer for this can be milk. Or, much more specifically, yogurt with the live and active cultures that work to recolonize the intestines. Unfortunately, time is still the best healer for temporary lactose intolerance from most of its causes.