Lactose Intolerance After Bariatric Surgery
A fair number of bariatric patients end up with lactose intolerance after surgery. Lactose is the sugar found in milk. During the rapid weight loss phase, you do lose some muscle mass. The digestive system is a muscle. When the digestive system loses a little of its muscle mass, it loses the ability to digest lactose, because we quit producing lactase, the enzyme that breaks down lactose.
Lactose is the type of sugar found in milk. Fluid milk and foods made from this can contain lactose. Examples of these kinds of foods include ice cream, a glass of milk, instant hot cocoa and pudding.Yogurt and cheese go through a fermentation process that actually breaks down some of the lactose. That’s why people with lactose intolerance can eat some yogurt and cheese.
Lactose can also be found in milk based protein supplements whether it’s the ready to drink or the protein powders. Milk based protein supplements will have the words whey, casein or milk in the ingredient list. Some protein supplements will actually state “Lactose Free” on the label.
Lactose can also be found in a protein product when the milk-based protein is from a “concentrate” form of whey, casein or milk. The protein is the concentrated form of whey, casein or milk. However, the protein is not isolated from the lactose. For example, whey protein isolate may have up to 1 percent of its weight as lactose. Whey concentrate may have up to 52 percent of its weight as lactose.
You can look at the Nutrition Facts Label to see if the protein product you choose has any sugar in it. If a type of milk or milk protein is listed on the ingredients, it could mean there is some lactose. A product that has 2 grams of sugar or less per serving are often safe to drink. If you are lactose intolerance, you’ve now got information to start looking for lactose in all the right places.
Rene Norman, RD/LD
René Norman, RD/LD is a registered and licensed dietitian. René has provided medical nutrition therapy for cardiovascular, diabetes, obesity, celiac disease, wellness and disease prevention in a variety of settings. While working in a private practice, René enjoyed counseling individuals and families and delivering presentations to schools, community groups and corporations. Guided by evidence based practices, emerging research, non-diet approaches to weight management and nearly a decade of experience with bariatric patients, René works with bariatric patients to educate them about nutrition before and after surgery.
Rene’ graduated from the University of Tulsa and completed her dietitian internship through Oklahoma State University. Rene’ is a member of the Academy of Nutrition and Dietetics, Oklahoma Academy of Nutrition and Dietetics and has served in leadership positions in local and state dietetics associations.
Thanks for the information and explanation of lactose intolerance and how it works. It may also be worth noting that a super important consequence of eating less dairy is the lack of Calcium intake. Milk, yogurt, cheese, and cottage cheese contain calcium, which is very important for bone health. All weight loss surgery patients need to be on top of their calcium intake, and you need to be even more careful to get in your supplements if you’re skipping the dairy products due to lactose intolerance.
Wow! I always joked that the doctor put in a special "no ice cream or milk" button in my sleeve. Even ranch dressing is a disaster, but cheese seems to be okay. Thanks for clearing this up!
Hi...wondering if I could have had this issue today. I am post-op day # 12 and today tried to eat Kefir (a yogurt style drink) which has a good amount of Protein per serving. I developed severe abdominal pain within the next few hours and was in bed the entire day! I thought I might have to go to the emergency room!!
Does this sound like lactose intolerance? All the while I had pain I heard gurgling in my stomach and (not to be gross) I was passing wind. I just had terrible cramping which only responded to pain medication and sleep.
What do you think?
RhondaSue 6
Posted
I am so so thankful to read this! I thought I was the only one after 5 years that wasn't able to drink milk or eat certain things, but still able to eat greek yogurt and cheese of all kinds...
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