Coping with ulcerative colitis and lactose intolerance
Introduction
They’re all out there: articles about which foods to avoid if you’re lactose intolerant, what not to eat if you suffer ulcerative colitis; even, what not to eat if you happen to have the misfortune of the double whammy of suffering both conditions in tandem. It all makes for depressing reading, especially when you have seronegative arthritis simmering away in the background, bringing us to even more depressing conclusions about the state we’re in. I’d suggest putting us out to grass, but grass is as hard as it gets to digest - it’s up there with fruit, vegetables, milk, cheese, butter, whole grains, nuts and seeds, chocolate, red meat; oh, and alcohol …just shoot us now!
What is not out there, quite so much, is what one can eat, and it is this that we’d most like to know.
Suffice to say, I’ve been chewing on about this situation (I make no excuses for the pun) for the best part of three years, now. I rant on, whenever I am dining in a restaurant, about the apparent lack of understanding by many in the food service industry as to what is meant by the term 'lactose-free'. Withering looks from bemused service staff, frenetic to-ing and fro-ing to the chef to check up on the ingredients in a dish short listed for the equivalent of a Booker prize before making a decision as to what to choose - or risk, as the case may be. The last time I looked, for example, eggs - at least the ones we’re prepared to eat - came from hens and not, strangely enough, from cows. So, when facing the prospect of deciding whether to chance the mayonnaise accompanying an otherwise risk-free baked potato, the accidental addition of butter notwithstanding, it is often implied that we might want to choose something else, since mayonnaise is made from eggs and olive oil. Yes, we know that, but some mass-produced varieties (incredibly) have milk products in them, too, and it’s the possible addition of these products that we’re checking up on, not whether the mayonnaise has eggs in it or not. Lactose has no shame, it turns up in the most surprising places, so don’t let it catch you out.
Choosing a diet that’s good for you
As with any diet, if what’s in it is not good for us, then we are bound to suffer consequences. These can manifest themselves as something vaguely irritating, such as a mild headache, to something infinitely more distressing. Moderation in what we eat is the watchword here, and must not be underrated; choose a healthy diet, eating what we need, not necessarily what we want. So, those slices of honey roast ham have to go, since (for those with ulcerative colitis) red meat is out of the question and so does the chocolate (for those who are lactose intolerant), because one tiny square never seems enough and before we know it, half the bar has disappeared and we’re sounding like a rocket on course for the moon. But, before we start re-stocking the fridge, it would help to clarify a bit of confusing terminology where food related allergies and intolerances are concerned.
Allergy or Intolerance? Lactose free or non-dairy?
Lactose free cheese or non-dairy cheese? How do we choose products that are lactose free or dairy free? On a par with tax evasion or tax avoidance, these phrases can be difficult to understand, at first. They are not one and the same, but there are similarities and subtle differences which can catch you out.
It generally follows that if one suffers from ulcerative colitis, then the inability to digest lactose can compound the problem. A hypersensitive reaction to certain types of food such as dairy is referred to as a food allergy, since it is our immune system which is reacting to the sugars and proteins found in milk products, in a way that doesn’t help us to digest the food properly. Conversely, food intolerance refers to an inability to digest certain food types because our digestive system does not produce the requisite lactase enzyme to help breakdown lactose into its constituent glucose and galactose. Symptoms are similar in both conditions and include wind, bloating, stomach cramps and rumbles, diarrhoea, and very rarely even anaphylaxis. Quite often, people complain of feeling bloated or uncomfortable after eating, but put it down to having eaten too much. It is quite possible that they have a degree of lactose intolerance but are unaware of it. In any event, and in particular when associated with ulcerative colitis, consultation with a medical professional would be wise.
Food labelling for lactose free products
In short, if you know you have an aversion to dairy products, or you suspect that you might, any food that is based on cows milk is best avoided. Even though the lactose might have been removed (hence, labelled as 'lactose free'), they are still dairy products. They should be safe for those of us who suffer a lactose intolerance, but as they contain other derivatives of milk, such as whey and casein, those with dairy allergies need to avoid them. Likewise, products labelled 'non-dairy' may still have milk products in them: casein, for example, typically makes up over half of the proteins found in milk produced from cows, and may be present in foods such as cheese which has been labelled 'non-dairy'. Food labelling in the UK is comprehensive enough to be able to determine whether or not the product is suitable for lactose or dairy-free diets, and known foods and their derivatives (including possible traces therein) are highlighted in bold if they are present and likely to affect some people by way of an allergic reaction or intolerance.
What to do if you think you might be lactose intolerant
As with any types of food which appear to cause digestive problems, it is wise to consider eliminating them from your diet for a period long enough to be able to determine any change. This goes for dairy products which should be excluded from your normal diet for a period of 2-3 weeks, making a note along the way of any other foods types which present problems. If symptoms do not improve, they’re less likely to be associated with the consumption of milk products. Reintroduction of milk products and subsequent reappearance of their adverse affects after 2-3 weeks, however, would suggest an intolerance to lactose and dietary changes can be made accordingly to minimise discomfort and improve wellbeing. A consultation with your doctor would help to ensure that you are otherwise in full health.
All is not lost: enjoying some favourite foods
You’d be surprised at the number of delicious recipes and dishes that can still be enjoyed whilst on a lactose or dairy free diet. With an ever-increasing range of lactose free ingredients it is easier than you might think to create everyday favourites from pates to puddings. Spend a little more time in the supermarkets to get to know which products are truly dairy free and experiment with them to understand their characteristics and how they perform in different recipes. A pure sunflower spread, for example, has a higher water content than traditional full fat butter, and but for the addition of an extra egg yolk would threaten the integrity of a hollandaise sauce beyond recognition. As it is, such a classic is never going to taste as it should with the absence of such high-fat content, but with practice and understanding of the role of all its ingredients when combined, does help to produce a credible alternative; Escoffier turning in his grave notwithstanding.
Lactose free recipes
Preparing and cooking meals from scratch, no matter how time-poor you might think you are, is rewarding and often a whole lot healthier with the added bonus of being aware of exactly what has gone into your meal. So, to cheer you up and get you started, here’s something to go with your mid-morning brew:
Lactose Free Ginger Nut Biscuits - Adapted over many bake-offs to be enjoyed for those on a lactose free diet, these biscuits are full of flavour, and have the hall marks of a good quality ginger nut biscuit: buttery taste, and a crunchy texture.
