April 2018

Lactose Brian Chicoine, MD Medical Director

People with Down syndrome can experience a variety of gastrointestinal issues. One of them is intolerance to foods containing lactose. Lactose is a sugar found in dairy products like milk and ice cream. While the exact incidence of in people with Down syndrome is not known, the condition is something a number of people with Down syndrome do experience.

Lactose is a two-molecule sugar that is broken into two parts in the intestines by an called . The two separated molecules can be absorbed through the intestinal wall. If the sugar isn’t broken down, the molecules can’t be broken down or absorbed. They sit in the intestine and can ferment causing symptoms. Symptoms can include:

• Abdominal pain • • •

Some individuals with Down syndrome who have a strong tendency towards being constipated do not get diarrhea (i.e. the they always experience is not overcome by the diarrhea associated with lactose intolerance). In these individuals, the other symptoms may be more prevalent.

Treatment can include: 1. Avoidance of dairy products that cause symptoms. 2. Eating or drinking food that has been pre-treated to break down lactose. For example, lactase-treated milk, which is available in grocery stores, has been treated with the enzyme lactase to allow for proper absorption. 3. Taking lactase medication. The enzyme lactase is available in pill and liquid forms and can be taken (preferably) before eating foods containing lactose to avoid symptoms.

Adult Down Syndrome Center 1610 Luther Lane, Park Ridge, IL 60068 847-318-2303

April 2018

In addition, celiac disease is more common in people with Down syndrome. Celiac disease and lactose intolerance can co-exist. People with Down syndrome treated for celiac disease sometimes have some persistent symptoms. It may be that they also have lactose intolerance and the residual symptoms are from lactose intolerance and not celiac disease. Both conditions need to be addressed for those individuals.

The links below take you to 1) a brief piece on recognizing the signs of lactose intolerance and 2) a blog post by registered and licensed dietitian Joan Medlen that includes information on lactose intolerance in people with Down syndrome.

1.) http://www.ahchealthenews.com/2018/04/06/know-signs-lactose-intolerance/ 2.) http://www.downsyndromenutrition.com/blog1/141-food-intolerance

Adult Down Syndrome Center 1610 Luther Lane, Park Ridge, IL 60068 847-318-2303