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Wednesday, April 14, 2010

Report From the LI Conference, part 23

The next presentation gives a useful follow-up to yesterday's post about the power of probiotics.

Treatment Recommendations in Adults With Diagnosed Lactose Intolerance
Jeanette N. Keith, M.D.
Associate Professor
Department of Nutrition Sciences
Department of Medicine
The University of Alabama at Birmingham

Probiotics can be helpful but people shouldn't expect to have them work instantly. In fact, any new dietary plan takes times to be effective.

In practice, we explain that just as it takes about 21 days to learn a new behavior, adaptation of the gut to a lactose-containing diet generally requires 3 weeks of consistent dietary change to achieve full tolerance.

As a nutritionist, rather than a research scientist, Dr. Keith had some crucial points that all practicing doctors should remember.

Patients like specifics rather than generalizations. That's the toughest thing for me to do, since I don't know you, don't know your medical history, don't know your symptoms, don't know all the little details that make up a life. Most of my advice here is generalized squared.

Doctors should do better, but too often they don't. A probiotic, for example, isn't a magic pill. Bacteria take time to multiply and drive out competing strains. If a doctor tells you to try them but nothing more, what do you do if you don't see improvement in three days? Or even a week? Many people would toss the probiotic and curse the doctor for making them spend unnecessary money. I'd much rather come out of a doctor's office knowing that I might have to wait for three possibly agonizing weeks for that wonderful symptom relief, even if I went in wanting that bit of magic.

Lactose intolerance is not a disease, despite what far too many people - and patients - think. The symptoms are all too real, though. Doctors need to understand what to ask about how people really eat, what tips to give, and how to steer individuals in the right direction.
The most effective dietary intervention for lactose intolerance is the one personalized to meet the needs of the individual affected by symptomatic lactose ingestion.

When you see your doctor, you need the best advice for you. Personally. I hope doctors are reading this.

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