Mimi Blank asks:

> My doc says lactose intolerance is usually caused by another disease. My
question to you is, what diseases can cause lactose intolerance besides CD?

Secondary lactose intolerance, as it is called, can be caused by a huge
number of diseases and conditions, basically anything that can disrupt the
delicate interior lining of the small intestine, where the lactase enzyme is
made.

These can include Crohn's disease (the CD that you mention?), giardiasis,
tropical sprue, Whipple's disease, and AIDS, as well as chronic alcohol
consumption, pelvic irradiation, malnutrition and many drugs. Of course,
massive invasive surgery to the intestines can also permanently knock out the
lactase-making facility.

However, since you mention celiac disease, that is almost surely the cause in
your case. Celiac disease, under whatever of the many names it goes by,
actually attacks the villi in which lactase in made and many people with this
problem wind up being LI.

You are doing the right thing by going on a gluten-free, milk-free diet. This
is a difficult thing to do completely, though, and you may be overlooking
some traces of these substances in your diet (hidden under "natural
flavorings" in ingredients lists, for example). I'm sure people here can help
you with questions you have about specific foods.

Steve Carper
Steve Carper's Lactose Intolerance Clearinghouse
http://ourworld.compuserve.com/homepages/stevecarper