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Robert,
        What you have experienced is fairly common in CD. Before I was
diagnosed, I tried a lactose free diet to stop my diarrhea. It certainly
helped. But because I wasn't on a gluten-free diet, I could have
occasional symptoms.
        The area in the intestines where lactase, the enzyme needed to
break down lactose, is produced is called the brush border. It is at the
ends of the microvilli. It is only one cell deep. As most people age,
their ability to produce lactase decreases. Sometimes it decreases to the
point where you are unable to deal with all of the lactase that you injest.
        If you have decreased production of lactase and then something
else happens to compromise the integrity of the brush border, it cases
further reduction of lactase production. If you continue to take in
lactose, that causes more irritation and loss of lactase production. It
becomes a vicious negative feedback cycle.
        When you are suffering from celiac sprue, there is damage to your
intestional villi. This can make one temporarily lactase deficient to the
point where lactose becaomes a problem also. This happened in my case.
Once I started on the gluten-free diet and my intestines had healed,
lactose was no longer a problem for me. I can eat any diary product now
with no problems.
        Not everyone will be so lucky. A lot of people will remaine
lactase deficient. Yogurt and aged cheeses are more easily tolerated
because some of the lactose has been converted to lactic acid. One rule
of thumb is that the higher the fat content of the dairy product, the
lower the lactase level. People who are still producing some lactase
would then be able to eat a very rich ice cream but would be bothered by
skim milk or ice milk.
        I highly recommend the book "No Milk Today". I'm sorry that I
can't remember the author's name. I found it at my local library. It's
anexcellent book for explaining the process, describing hidden sources of
lactose (like whey), and tips on eating out.
        So, even though lactase deficiency and gluten intolerance can
give the same symptoms, they are not caused by the same processes.
Lactase is composed of two sugars. The problems arise when you are unable
to break it into its two parts and absorb them.
        Gluten ia a protein. It seems to cause a problem due to and
immunological re As far as I know, there is no similarities between
        I hope this is helpful.
        Ellen Eagan
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