New diet

Question
My doctor recently tested me for celiac disease and lactose intolerance in response to a visit about abdominal pain.  The celiac disease test was negative, but it turns out that I am very lactose intolerant.  My doctor also had me take medicine for spastic colon.  The medicine and a lactose-free diet did help and the pain is much less than it used to be. My doctor is having me slowly stop taking the medicine and has told me to slowly reintroduce milk into my diet.  I have a few questions about this.  I had spoken with a nutritionist about milk-free and she gave me a bunch of print outs about what to look for in ingredient lists that might be hidden dairy.  I followed this very strictly for the last 3 weeks.  When my doctor said to slowly reintroduce dairy, does that mean that I should stop reading labels and just avoid obvious dairy, or should I just do little amounts of any type of dairy every few days?  My next question is about getting calcium without milk.  I wasn't a big fan of milk before, but I did eat yogurt and cheese.  I have tried almond yogurt and it is alright, but so expensive I can't afford to eat one of those a day.  Plus there isn't that much calcium in one of those containers.  I do take a multi-vitamin that has calcium so should I even worry?  My husband and I are planning on trying to get pregnant in the next month or so and I want to make sure that I am not in pain, but that I have enough calcium and other vitamins and nutrients in my diet that I would be missing with milk and yogurt. My next question is about lactaid.  The other nutritionist said it would be better to know my limits with lactose before trying lactaid and dairy food, but my doctor seems to think that if I really want, say a piece of pizza, a lactaid before will be fine.  Thank you.

Answer
Hi Erin, as I'm not a medical professional I will try my best to give you a clear and in depth answer.
First off lactose intolerance is not so much an issue with dairy as it is with lactose, or milk sugar. Milk itself will usually contain the greater amount of lactose. Cheese and yogurt typically will have lower amounts in them.
You mention you are getting conflicting information from your doctor and nutritionist. If you truly trust your doctor it is best to always go with their recommendation. It is actually bad practice for any nutrition expert to advise a client against doctors orders.

I did so some research for you and according to the U.S. National Library of Medicine, yogurt and aged or hard cheeses are found to be easier to digest for persons with lactose problems.

Basically your body lacks or is short on the enzyme lactase. In digestion different enzymes are responsible for breaking down different nutrients.
You can supplement lactase which is what your doctor has recommended. In a way I agree with the nutritionist that it is better to access your limits without the intervention of any type of medication or supplement, but in this sense a lactase supplement is not a chemical drug.
This is purely my suggestion and I would recommend you clear it with your doctor first but try to eat some yogurt or cheese and see how you feel. If you find that it is not agreeing with you then try the lactase supplement.
I would suggest going with a Greek yogurt as they are more nutrient dense and contain greater amounts of protein.

As far as the calcium goes it is best to get as many nutrients into your body as possible when trying to conceive and when pregnant. This is where a good prenatal vitamin supplement comes in. GNC stores actually sell a vitamin kit for pregnant women that contains a multivitamin, calcium and a fish oil supplement. It sells for around $25.00 for a 30 day supply. You might want to go to www.gnc.com and look up their prenatal program product, I looked up the item number for you 286512. Look under the HEALTH NOTES tab, there is some really great information there about nutrients and pregnancy.

So hopefully I was of some help here. Best of luck to you and if need be feel free to write back.

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