Lactose Intolerance - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

LACTOSE

INTOLERANCE A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Lactose Intolerance: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83997-2 1. Lactose Intolerance-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on lactose intolerance. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON LACTOSE INTOLERANCE ........................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Lactose Intolerance........................................................................ 9 The National Library of Medicine: PubMed ................................................................................ 11 CHAPTER 2. NUTRITION AND LACTOSE INTOLERANCE ................................................................. 45 Overview...................................................................................................................................... 45 Finding Nutrition Studies on Lactose Intolerance....................................................................... 45 Federal Resources on Nutrition ................................................................................................... 47 Additional Web Resources ........................................................................................................... 48 CHAPTER 3. ALTERNATIVE MEDICINE AND LACTOSE INTOLERANCE ........................................... 49 Overview...................................................................................................................................... 49 National Center for Complementary and Alternative Medicine.................................................. 49 Additional Web Resources ........................................................................................................... 54 General References ....................................................................................................................... 56 CHAPTER 4. PATENTS ON LACTOSE INTOLERANCE ....................................................................... 57 Overview...................................................................................................................................... 57 Patents on Lactose Intolerance..................................................................................................... 57 Patent Applications on Lactose Intolerance ................................................................................. 59 Keeping Current .......................................................................................................................... 61 CHAPTER 5. BOOKS ON LACTOSE INTOLERANCE ........................................................................... 63 Overview...................................................................................................................................... 63 Book Summaries: Federal Agencies.............................................................................................. 63 Book Summaries: Online Booksellers........................................................................................... 66 The National Library of Medicine Book Index ............................................................................. 67 Chapters on Lactose Intolerance................................................................................................... 68 CHAPTER 6. MULTIMEDIA ON LACTOSE INTOLERANCE ................................................................ 81 Overview...................................................................................................................................... 81 Video Recordings ......................................................................................................................... 81 Bibliography: Multimedia on Lactose Intolerance ....................................................................... 83 CHAPTER 7. PERIODICALS AND NEWS ON LACTOSE INTOLERANCE ............................................. 85 Overview...................................................................................................................................... 85 News Services and Press Releases................................................................................................ 85 Newsletters on Lactose Intolerance.............................................................................................. 87 Newsletter Articles ...................................................................................................................... 88 Academic Periodicals covering Lactose Intolerance ..................................................................... 89 CHAPTER 8. RESEARCHING MEDICATIONS .................................................................................... 91 Overview...................................................................................................................................... 91 U.S. Pharmacopeia....................................................................................................................... 91 Commercial Databases ................................................................................................................. 92 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 95 Overview...................................................................................................................................... 95 NIH Guidelines............................................................................................................................ 95 NIH Databases............................................................................................................................. 97 Other Commercial Databases....................................................................................................... 99 The Genome Project and Lactose Intolerance............................................................................... 99 APPENDIX B. PATIENT RESOURCES ............................................................................................... 103 Overview.................................................................................................................................... 103 Patient Guideline Sources.......................................................................................................... 103 Finding Associations.................................................................................................................. 108

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APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 111 Overview.................................................................................................................................... 111 Preparation................................................................................................................................. 111 Finding a Local Medical Library................................................................................................ 111 Medical Libraries in the U.S. and Canada ................................................................................. 111 ONLINE GLOSSARIES................................................................................................................ 117 Online Dictionary Directories ................................................................................................... 119 LACTOSE INTOLERANCE DICTIONARY ............................................................................. 121 INDEX .............................................................................................................................................. 157

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with lactose intolerance is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about lactose intolerance, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to lactose intolerance, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on lactose intolerance. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to lactose intolerance, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on lactose intolerance. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON LACTOSE INTOLERANCE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on lactose intolerance.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and lactose intolerance, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “lactose intolerance” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Lactose Intolerance (editorial) Source: New England Journal of Medicine. 333(1): 53-54. July 6, 1995. Summary: In this letter to the New England Journal of Medicine, the author comments on a research report on lactose intolerance published in the same issue. The author of this editorial focuses on the difference between people who attribute abdominal symptoms to lactose intolerance and those who ignore the same symptoms. The research study found that, when lactose intake is limited to the equivalent of 240ml of milk or less per day, symptoms are likely to be negligible and the use of lactosedigestive aids unnecessary. The author of this editorial contends that the interplay of mind and body is critical in the development of abdominal symptoms. 14 references. (AA-M).

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Lactose Intolerance: Problems in Diagnosis and Treatment Source: Journal of Clinical Gastroenterology. 28(3): 208-216. April 1999. Contact: Available from Lippincott-Raven Publishers. P.O. Box 1550, Hagerstown, MD 21741. (800) 638-3030 or (301) 714-2300. Summary: Lactose (milk sugar) malabsorption and lactase deficiency are chronic organic pathologic conditions characterized by abdominal pain and distention, flatulence (gas), and the passage of loose, watery stools. This article reviews problems in the diagnosis and treatment of lactose intolerance. Though malabsorption of sugar lactose can be determined by breath hydrogen test or jejunal biopsy, intolerance can be confirmed only by challenge with food containing lactose, and the response to it may not be immediate. The difficulty of making a positive diagnosis of these conditions has led to a proportion of lactose intolerant patients being misdiagnosed with irritable bowel syndrome (IBS), which has a remarkably similar symptom complex and for which there is no current pathophysiologic marker. The incidence of the two disorders is approximately equal, but the actual proportion of patients with IBS incorrectly diagnosed in this way varies as a function of the methodology used. Once the correct diagnosis is established, introduction of a lactose free dietary regime relieves symptoms in most patients. Symptom similarity and the resultant incorrect diagnosis of IBS may explain the refractory nature of some patients who are thought to have IBS and remain largely unaware of the relationship between food intake and symptoms. 4 tables. 80 references. (AA).

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Lactose Intolerance: Recognizing the Link Between Diet and Discomfort Source: Postgraduate Medicine. 95(1): 113-120. January 1994. Summary: Lactose intolerance is highly prevalent among certain ethnic populations and should be suspected when evaluating gastrointestinal complaints in members of these groups. In this article, the authors discuss methods of clinical evaluation and offer basic dietary recommendations for patients with lactose intolerance. Topics covered include the prevalence of lactose intolerance in the U.S. adult population; types of lactase deficiency, including primary, secondary, and congenital; the causes of lactose intolerance; clinical evaluation methods, including the lactose tolerance test, breath hydrogen test, and small-bowel biopsy; and dietary management and patient monitoring. The authors caution that lack of suspicion of the problem can lead to expensive and invasive diagnostic procedures, which may further aggravate patients' anxiety and result in iatrogenic complications. 1 figure. 3 tables. 11 references. (AA-M).

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When to Suspect Lactose Intolerance: Symptomatic, Ethnic, and Laboratory Clues Source: Postgraduate Medicine. 104(3): 109-111, 115-116, 122-123. September 1998. Summary: Lactose intolerance is the inability to digest significant amounts of lactose (the sugar found in milk and dairy products). Lactose intolerance affects millions of people worldwide and should be suspected particularly when evaluating gastrointestinal symptoms in ethnic populations in which it is prevalent. The authors of this article discuss symptoms and methods of detection and offer their recommendations for helping patients with this common disorder. Daily ingestion of less than 240 mL of milk is well tolerated by most adults with lactose intolerance. Some persons with normal lactase activity may become symptomatic after consuming products containing lactose. Lactose maldigestion can coexist in adults with irritable bowel syndrome (IBS) and in children with recurrent abdominal pain. Management

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consists primarily of dietary changes. People who avoid dairy products should receive calcium supplementation and should be advised to read ingredient labels carefully. Several lactase replacement products are available, but their efficacy varies. One sidebar discusses hidden sources of lactose, listing common foods that may contain lactose. 4 tables. 21 references. (AA-M). •

Commonsense Approach to Lactose Intolerance Source: Patient Care. 31(7): 185-190, 195. April 15, 1997. Contact: Available from Medical Economics. 5 Paragon Drive, Montvale, NJ 07645. (800) 432-4570. Fax (201) 573-4956. Summary: Many adults avoid milk and milk products because they believe that even small quantities of lactose will cause diarrhea, bloating, and flatulence resulting from lactose intolerance. However, the author of this article stresses that nearly everyone can tolerate moderate amounts of lactose. A sizable fraction of people self-diagnosed as having lactose intolerance actually absorb lactose completely, and virtually all lactose malabsorbers tolerate moderate amounts of lactose without exhibiting discernible symptoms. The author describes the importance of milk in the adult diet, notably to counter the bone loss usually observed in middle and late adulthood. An additional section describes lactose digestion and lactase activity. One sidebar explores the physiology of lactose digestion in detail. Lactose digestive aids are available in several formulations at varying cost; these include lactase-containing drops and tablets that resist acid-peptic denaturation in the stomach. The author concludes by describing how the symptomatic and breath-hydrogen response of people with lactase nonpersistence appears to decrease when they regularly consume large amounts of lactose. This improved tolerance apparently reflects an adaptation by the colonic flora, resulting in increased metabolism of lactose via non-gas-forming reactions. 1 figure. 2 tables. 5 references.

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Weight-Gain Arrest Secondary to Lactose Intolerance Source: JAAPA. Journal of the American Academy of Physician Assistants. 11(1): 19-20, 25. January 1998. Contact: Available from Medical Economics. 5 Paragon Drive, Montvale, NJ 07645. (800) 432-4570. Fax (201) 573-4956. Summary: There are many reasons that an infant may fail to grow, but food intolerance is often the culprit. This article explores problems of lactose intolerance in infants. Lactose intolerance is particularly significant in infants because milk is the major component of their diet. Severe symptoms of diarrhea, intestinal gas, and nausea can result in malnutrition and lack of weight gain. The authors help readers understand the mechanisms of lactose intolerance in order to better manage patients with this problem. The article begins with a case presentation of a 17 month old girl with a 10 month history of arrested weight gain. The authors use this case to demonstrate how the growth curves can be used to diagnose problems. Lactose intolerance results when the body cannot produce lactase, the enzyme that hydrolyzes lactose to glucose and galactose. When this enzyme is absent or deficient, lactose accumulates in the gut. Subsequent fermentation in the gut produces gas and acidic contents. Familial investigations have established that the persistence of lactose absorption is inherited as an autosomal dominant characteristic. Secondary disaccharidase deficiency (SDD) is not hereditary. This disorder of the small intestine involves diffuse mucosal injury caused by several mechanisms and results in diminished activity of all the disaccharidases. The

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authors briefly review the diagnostic tests used to determine lactose intolerance. They also note that lactose tolerance can be spontaneously restored if the patient has no latent genetic predisposition to hereditary lactase deficiency (HLD) and if damage to the mucosa heals. 2 figures. 12 references. •

Managing Lactose Intolerance Source: Dairy Council Digest. 65(2): 7-12. March-April 1994. Contact: Available from National Dairy Council. O'Hare International Center, 10255 West Higgins Road, Suite 900, Rosemont, IL 60018-5616. Summary: This article addresses the issues involved in managing lactose intolerance, the occurrence of gastrointestinal symptoms resulting from the inability to digest lactose, the predominant carbohydrate in human and cow's milks. The article provides information about development, causes and symptoms of lactose-reduced milk products; lactase activity in various ethnic and racial populations and age groups; diagnostic tests; dairy foods that may be tolerated; increasing tolerance of dairy foods; prevalence of lactose maldigestion; the dietary management of lactose maldigestion; and specific dairy items and their place in an adequate, well-tolerated diet. 1 table. 48 references.

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Comparison of Symptoms After the Consumption of Milk or Lactose-Hydrolyzed Milk by People With Self-Reported Severe Lactose Intolerance Source: New England Journal of Medicine. 333(1): 1-4. July 6, 1995. Summary: This article reports on a randomized, double-blind, crossover trial in which researchers evaluated gastrointestinal (GI) symptoms in 30 people (mean age, 29.4 years) who reported severe lactose intolerance and consistent symptoms after ingesting less than 240 ml (8 oz) of milk. The ability to digest lactose was assessed in all participants (21 had lactose malabsorption; 9 were able to absorb lactose). Subjects then received either 240 ml of lactose-hydrolyzed milk containing 2 percent fat, or 240 ml of milk containing 2 percent fat and sweetened with aspartame to approximate the taste of lactose-hydrolyzed milk; each type of milk was administered daily with breakfast for a 1-week period. Using a standardized scale, subjects rated the occurrence and severity of bloating, abdominal pain, diarrhea, and recorded each passage of gas. During the study periods, GI symptoms were minimal. When the periods were compared, there were no statistically significant differences in the severity of the four GI symptoms measured. The authors conclude that people who identify themselves as severely lactose-intolerant may mistakenly attribute a variety of abdominal symptoms to lactose intolerance. When lactose intake is limited to the equivalent of 240 ml of milk or less per day, symptoms are likely to be negligible and the use of lactose-digestive aids unnecessary. 1 figure. 1 table. 27 references. (AA-M).

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Lactose Intolerance and Chemotherapy Source: Newsletter for People with Lactose Intolerance and Milk Allergy. p. 4-5. Fall 1992. Contact: Available from Jane Zukin. Commercial Writing Service, P.O. Box 3129, Ann Arbor, MI 48106-3129. Summary: This article reviews chemotherapy used to treat cancer and special implications for cancer patients who have lactose intolerance. Topics covered include the role of nutrition in cancer therapy; consulting a dietitian for recommendations; the

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role of the family; problems with nausea and vomiting caused by chemotherapy; problems with lactose absorption in all patients undergoing chemotherapy; secondary lactose intolerance; and recommendations for treating mouth sores caused by chemotherapy. 2 references. •

Lactose Intolerance: Pinpointing the Source of Nonspecific Gastrointestinal Symptoms Source: Postgraduate Medicine. 89(8): 175-184. June 1991. Summary: This article reviews the condition of lactose intolerance, focusing on the role of lactose intolerance in nonspecific gastrointestinal symptoms. The authors explain how children and adults lose the ability to absorb lactose and describe clinical symptoms of malabsorption, objective methods to diagnose it, and practical ways to avoid the symptoms. The authors recommend the hydrogen breath test as a simple, noninvasive, accurate, and inexpensive method for diagnosis. They note that in addition to traditional dietary restriction of lactose, treatment may consist of alterations in dietary fat content or caloric density to reduce symptoms and use of dairy products or additives that provide lactase activity. (AA-M).

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Recognizing and Alleviating the Symptoms of Lactose Intolerance Source: Digestive Health and Nutrition. p. 16-20. November-December 1999. Contact: Available from American Gastroenterological Association. 7910 Woodmont Avenue, 7th Floor, Bethesda, MD 20814. (877) DHN-4YOU or (301) 654-2055, ext. 650. Email: [email protected]. Summary: This article reviews the symptoms of lactose intolerance and offers strategies for alleviating those symptoms. The author notes that many adults lose their ability to digest milk after childhood. The culprit, a sugar called lactose that is found in dairy products, cannot be absorbed by the body unless it is broken down by an enzyme called lactase in the digestive system. Most people produce less lactase as they age, and this can result in a very uncomfortable, but rarely dangerous, disorder called lactose intolerance. Without the help of a physician, lactose intolerance can be a tricky disorder to diagnose for a number of reasons: the symptoms are similar to many other food intolerance problems, and the different tolerance levels in different people. Lactose can be present in many different foods and even in medications (20 percent of prescription drugs and about 6 percent of over the counter medications contain lactose). The article outlines the diagnostic tests used to confirm lactose intolerance and then offers suggestions for readers who definitely are lactose intolerant. The author cautions that eliminating all dairy products can cause other problems, including a shortage of calcium and other nutrients. For most people with lactose intolerance, eliminating some, but not necessarily all, dairy products is an options. Research studies have shown that people with confirmed low levels of lactase can still consume one serving of milk with a meal or as many as two servings per day when divided between breakfast and dinner, without experiencing symptoms. In addition, some dairy products have less lactose than others. Over the counter drops and tablets containing lactase also are available to assist with the digestion of dairy products without discomfort. The article concludes with the web sites of organizations from which readers can get additional information. 3 tables. 3 references.

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Lactose Intolerance and Children Source: Digestive Health and Nutrition. p. 6. July-August 2002.

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Contact: Available from American Gastroenterological Association. 7910 Woodmont Avenue, 7th Floor, Bethesda, MD 20814. (877) DHN-4YOU or (301) 654-2055, ext. 650. Email: [email protected]. Summary: This brief article discusses lactose intolerance and children. True infancy lactose intolerance is rare because most full-term babies are born with a sufficient amount of lactase, the enzyme required for the body to break down lactose (milk sugar). Once a young child does start to lose his ability to produce lactase, the symptoms he experiences when encountering lactose levels higher than he can tolerate are similar to those manifested in adults: gas, bloating, diarrhea, or abdominal cramping, anywhere between 30 minutes and a few hours after ingestion. The author briefly discusses issues of diagnosis, and the differences between lactose intolerance and milk allergy. •

Will My Child Outgrow Lactose Intolerance? Source: Newsletter for People with Lactose Intolerance and Milk Allergy. Winter 1992. 2 p. Contact: Available from Newsletter for People with Lactose Intolerance and Milk Allergy. P.O. Box 3129, Ann Arbor, MI 48106-3129. (313) 572-9134. Summary: This brief article discusses problems children may have with milk: lactose intolerance and milk allergy. The author clarifies the differences between the two, focusing on the likelihood of remission and changing ability to ingest milk and milk products as a child matures. The author cautions that continual ingestion of cow's milk protein by children sensitive to it can cause damage to the intestinal lining that may be permanent.

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Lactose Intolerance and Ovarian Cancer Source: Newsletter for People with Lactose Intolerance and Milk Allergy. p. 3-4. Spring 1991. Contact: Available from Newsletter for People with Lactose Intolerance and Milk Allergy. P.O. Box 3129, Ann Arbor, MI 48106-3129. (313) 572-9134. Summary: This brief article reports on a recent research theory that excess galactose (a component of lactose) may cause a hormonal imbalance that triggers ovarian tumors. If this theory is correct, avoiding lactose-rich foods may reduce the threat of ovarian cancer in patients with low levels of the enzyme needed to metabolize galactose.

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Got Lactose Intolerance? Source: Digestive Health and Nutrition. 4(1):20. January-February 2002. Contact: Available from American Gastroenterological Association. 7910 Woodmont Avenue, 7th Floor, Bethesda, MD 20814. (877) DHN-4YOU or (301) 654-2055, ext. 650. Email: [email protected]. Summary: This brief newsletter article familiarizes readers with lactose (milk sugar) intolerance and how to determine the level of one's own lactose intolerance. The author reports on a recent study in which a group of self-diagnosed individuals were tested for lactose intolerance and 31 percent comfortably digested two cups of milk. For those with severe lactose intolerance, total avoidance of milk products may be necessary. However, there are degrees to lactase deficiency. Lactase is the enzyme in the human digestive system that breaks down lactose. Symptoms of lactose intolerance occur only when the individual takes in more lactose than can be broken down by the lactase in their system.

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The author stresses than an unnecessary restriction to one's diet is not appropriate unless a physician has diagnosed lactose intolerance. When trying to determine the body's level of tolerance, the best method is trial and error. Once a person knows his or her level of tolerance, they can work toward improving their tolerance for dairy foods by consistently including them in the diet, spread throughout the day so as not to overwhelm the body. The article concludes with the websites of three organizations through which readers can get additional information. 3 references. •

Lactose Intolerance: The Full Story Source: Ostomy Quarterly. 32(2): 24-26. Spring 1995. Contact: Available from United Ostomy Association, Inc. 36 Executive Park, Suite 120, Irvine, CA 92714-6744. (800) 826-0826 or (714) 660-8624. Summary: This newsletter article familiarizes readers with lactose intolerance. Topics include causes; diagnostic tests; foods that contain lactose; medications that contain lactose; and treatment options. The article concludes with a list of resources through which readers can obtain additional information. 1 table.

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Allaying Fears and Fallacies About Lactose Intolerance Source: Journal of the American Dietetic Association. 98(6): 671-676. June 1998. Summary: This review article is intended to help dietetic professionals alleviate clients fears about lactose intolerance and recommend dietary strategies to improve tolerance. Public awareness and misunderstanding of lactose intolerance are at an all-time high. Many people erroneously believe that they develop gastrointestinal symptoms after ingesting lactose. Consequently, lactose-containing foods such as milk and other dairy products may be eliminated unnecessarily from the diet. Because these foods are a major source of calcium, low intake can compromise calcium nutrition. This, in turn, can increase the risk of major chronic diseases such as osteoporosis (porous bones) and hypertension. Scientific study indicates that the prevalence of lactose intolerance is grossly overestimated. Other physiologic and psychologic factors can contribute to gastrointestinal symptoms that mimic lactose intolerance. Scientific findings also indicate that people with laboratory-confirmed low levels of lactase can consume one serving of milk with a meal or two servings of milk per day in divided doses at breakfast and dinner without experiencing symptoms. Several dietary strategies are available to help lactose maldigesters include milk and other dairy foods in their diet without experiencing symptoms. These include the use of lactose-reduced or lactose-free dairy foods, lactose digestive aids, and a gradual increase in intake of dairy foods. 2 tables. 57 references. (AA).

Federally Funded Research on Lactose Intolerance The U.S. Government supports a variety of research studies relating to lactose intolerance. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable

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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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Lactose Intolerance

database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to lactose intolerance. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore lactose intolerance. The following is typical of the type of information found when searching the CRISP database for lactose intolerance: •

Project Title: BUILDING BETTER BONES IN CHILDREN Principal Investigator & Institution: Zemel, Babette S.; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 01-JUN-1999; Project End 31-MAY-2004 Summary: Increased calcium intake has proven effective in increasing bone mineral density in children, but the effect disappears when calcium supplements are discontinued. Increased dietary calcium from daily and other food sources may have an even greater impact on bone density than that achieved by calcium supplements, but achieving sustained increased calcium from food sources has not been demonstrated. In addition, the effects of baseline characteristics of calcium intake and bone density and puberty status may influence the response to intervention. This study will develop and implement a Behavioral Modification-Nutrition Education (BM-NE) Intervention Program aimed at increasing dietary calcium Male and female subjects (n=154), ages 710 years (Tanner stage I or II), will be randomly assigned to participate in an intensive BM-NE intervention group to increase intake to 1500 mg/d or a group that will receive usual care (UC) as counseling on bone health. The BM-NE Program will consist of five separate group sessions for parents and children over a five to six week period, and use individualized plans to increase calcium intake. Participants will be recruited into two groups: a group of healthy children (i.e.,no known chronic disease or previous oral steroid exposure) with no known risk factors, and a group of healthy children with potential risk factors for low bone density (previous fracture from usual childhood activities, daily refusal, or lactose intolerance, family history of osteoporosis). These two groups will be equally represented in their assignment to BM-NE and UC groups. This latter strategy will be used to determine whether the presence of risk factors influences participant compliance with the programs. We hypothesize that (a) at the end of 36 months the BM-NE group will have increased dietary calcium of at least 300 mg/d in the no-risk BM-NE group compared to those receiving UC, (b) baseline calcium intake and presence of risk factors will be associated with changes in calcium intake over the course of the study, and (c) after controlling for important co-variates such as increases in body size and sexual and skeletal maturation, changes in BMD will be associated with calcium intake and physical activity. These findings will help define important behavioral strategies for increasing peak bone mass and prevention of osteoporosis later in life that can be implemented in a short period of time with long-lasting effects. Furthermore, it will help quantify the impact of increased dietary calcium on bone density during growth and development with possible identification of the characteristics of children most in need of and responsive to this treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SYMPTOMS CONSUMPTION

OF

LACTOSE

INTOLERANCE

AFTER

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MILK

Principal Investigator & Institution: Bahar, Ronald; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2001 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with lactose intolerance, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “lactose intolerance” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for lactose intolerance (hyperlinks lead to article summaries): •

A boy with severe infantile gastrogen lactose intolerance and acquired lactase deficiency. Author(s): Berg NO, Dahlqvist A, Lindberg T. Source: Acta Paediatr Scand. 1979 September; 68(5): 751-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=525343&dopt=Abstract

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A comparison of symptoms after the consumption of milk or lactose-hydrolyzed milk by people with self-reported severe lactose intolerance. Author(s): Suarez FL, Savaiano DA, Levitt MD. Source: The New England Journal of Medicine. 1995 July 6; 333(1): 1-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7776987&dopt=Abstract

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A randomized trial of Lactobacillus acidophilus BG2FO4 to treat lactose intolerance. Author(s): Saltzman JR, Russell RM, Golner B, Barakat S, Dallal GE, Goldin BR. Source: The American Journal of Clinical Nutrition. 1999 January; 69(1): 140-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9925136&dopt=Abstract

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PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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Abdominal pain associated with lactose ingestion in children with lactose intolerance. Author(s): Gremse DA, Greer AS, Vacik J, DiPalma JA. Source: Clinical Pediatrics. 2003 May; 42(4): 341-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12800728&dopt=Abstract

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Abstinence from smoking and expired-air carbon monoxide levels: lactose intolerance as a possible source of error. Author(s): McNeill AD, Owen LA, Belcher M, Sutherland G, Fleming S. Source: American Journal of Public Health. 1990 September; 80(9): 1114-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2382751&dopt=Abstract

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Acquired lactose intolerance: a seldom considered cause of diarrhea in the palliative care setting. Author(s): Noble S, Rawlinson F, Byrne A. Source: Journal of Pain and Symptom Management. 2002 June; 23(6): 449-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12067764&dopt=Abstract

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Acrodermatitis enteropathica with lactose intolerance. Author(s): Milla PJ, Moynahan EJ. Source: Proc R Soc Med. 1972 July; 65(7): 600-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5085934&dopt=Abstract

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Acrodermatitis enteropathica with secondary lactose intolerance, and tertiary deficiency state, probably due to chelation of essential nutrients by diiodohydroxyquinolone. Author(s): Moynahan EJ. Source: Proc R Soc Med. 1966 May; 59(5): 445-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5326958&dopt=Abstract

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Alactasia. Author(s): Davis AE. Source: The Medical Journal of Australia. 1972 August 19; 2(8): 431-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5086304&dopt=Abstract

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Allaying fears and fallacies about lactose intolerance. Author(s): McBean LD, Miller GD. Source: Journal of the American Dietetic Association. 1998 June; 98(6): 671-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9627625&dopt=Abstract

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An ethnic difference--lactose intolerance. Author(s): Hongladarom GC, Russell M. Source: Nursing Outlook. 1976 December; 24(12): 764-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1049853&dopt=Abstract

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An investigation of milk-drinking habits of University of Hawaii students as a possible indication of lactose intolerance. Author(s): Hastings K, Hilker DM. Source: Hawaii Med J. 1976 July; 35(7): 197-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=989045&dopt=Abstract

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Asian lactose intolerance and its relation to intake of lactose. Author(s): Bolin TD, Davis AE. Source: Nature. 1969 April 26; 222(191): 382-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5818695&dopt=Abstract

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Assisting families in making appropriate feeding choices: cow's milk protein allergy versus lactose intolerance. Author(s): Baron ML. Source: Pediatric Nursing. 2000 September-October; 26(5): 516-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12026343&dopt=Abstract

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Beta-galactosidase tablets in the treatment of lactose intolerance in pediatrics. Author(s): Medow MS, Thek KD, Newman LJ, Berezin S, Glassman MS, Schwarz SM. Source: Am J Dis Child. 1990 November; 144(11): 1261-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2122719&dopt=Abstract

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Biogenesis of intestinal lactase-phlorizin hydrolase in adults with lactose intolerance. Evidence for reduced biosynthesis and slowed-down maturation in enterocytes. Author(s): Sterchi EE, Mills PR, Fransen JA, Hauri HP, Lentze MJ, Naim HY, Ginsel L, Bond J. Source: The Journal of Clinical Investigation. 1990 October; 86(4): 1329-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1976654&dopt=Abstract

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Bone density in axial and appendicular skeleton in patients with lactose intolerance: influence of calcium intake and vitamin D status. Author(s): Segal E, Dvorkin L, Lavy A, Rozen GS, Yaniv I, Raz B, Tamir A, Ish-Shalom S. Source: Journal of the American College of Nutrition. 2003 June; 22(3): 201-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12805246&dopt=Abstract

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Burning issues. A guide for patients. Lactose intolerance. Author(s): Bursey RF. Source: Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie. 1999 March; 13(2): 107. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10203425&dopt=Abstract

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Calcium absorption from milk and lactose-free milk in healthy subjects and patients with lactose intolerance. Author(s): Kocian J, Skala I, Bakos K. Source: Digestion. 1973 November; 9(4): 317-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4801172&dopt=Abstract

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Chemotherapy-induced lactose intolerance in adults. Author(s): Parnes HL, Fung E, Schiffer CA. Source: Cancer. 1994 September 1; 74(5): 1629-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8062196&dopt=Abstract

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Clinical aspects of lactose intolerance in children and adults. Author(s): Buller HA, Rings EH, Montgomery RK, Grand RJ. Source: Scandinavian Journal of Gastroenterology. Supplement. 1991; 188: 73-80. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1775944&dopt=Abstract

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Clinical picture of hypolactasia and lactose intolerance. Author(s): Villako K, Maaroos H. Source: Scandinavian Journal of Gastroenterology. Supplement. 1994; 202: 36-54. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8042017&dopt=Abstract

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Clinical tests for hypolactasia, lactose malabsorption and lactose intolerance. Author(s): Taylor RH. Source: Lancet. 1982 October 2; 2(8301): 766. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6125831&dopt=Abstract

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Close relationship between lactose intolerance and allergy to milk protein. Author(s): Matsumura T, Kuroume T, Amada K. Source: J Asthma Res. 1971 September; 9(1): 13-29. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5171659&dopt=Abstract

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Cocoa feeding and human lactose intolerance. Author(s): Lee CM, Hardy CM. Source: The American Journal of Clinical Nutrition. 1989 May; 49(5): 840-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2718917&dopt=Abstract

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Colonic adaptation to daily lactose feeding in lactose maldigesters reduces lactose intolerance. Author(s): Hertzler SR, Savaiano DA. Source: The American Journal of Clinical Nutrition. 1996 August; 64(2): 232-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8694025&dopt=Abstract

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Comparison of lactose intolerance in healthy Kuwaiti and Asian volunteers. Author(s): Al-Sanae H, Saldanha W, Sugathan TN, Majid Molla A. Source: Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre. 2003 July-September; 12(3): 160-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12766333&dopt=Abstract

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Congenital lactose intolerance of gastrogen origin associated with cataracts. Author(s): Russo G, Mollica F, Mazzone D, Santonocito B. Source: Acta Paediatr Scand. 1974 May; 63(3): 457-60. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4209121&dopt=Abstract

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Congenital sucrase and isomaltase deficiency with temporary lactose intolerance. Author(s): Marshall WC, Lloyd-Still J, Seakins JW. Source: Acta Paediatr Scand. 1967 March; 56(2): 211-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6049803&dopt=Abstract

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Correlation of lactose maldigestion, lactose intolerance, and milk intolerance. Author(s): Johnson AO, Semenya JG, Buchowski MS, Enwonwu CO, Scrimshaw NS. Source: The American Journal of Clinical Nutrition. 1993 March; 57(3): 399-401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8438774&dopt=Abstract

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Cows' milk protein intolerance: a possible association with gastroenteritis, lactose intolerance, and IgA deficiency. Author(s): Harrison M, Kilby A, Walker-Smith JA, France NE, Wood CB. Source: British Medical Journal. 1976 June 19; 1(6024): 1501-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=776336&dopt=Abstract

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Determination of lactose intolerance by breath analysis. Author(s): Calloway DH, Murphy EL, Bauer D. Source: Am J Dig Dis. 1969 November; 14(11): 811-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5358883&dopt=Abstract

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Diagnosis and treatment of lactose intolerance. Author(s): Seely S. Source: British Medical Journal (Clinical Research Ed.). 1982 February 20; 284(6315): 598. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6800558&dopt=Abstract

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Diagnosis and treatment of lactose intolerance. Author(s): Ferguson A. Source: British Medical Journal (Clinical Research Ed.). 1981 November 28; 283(6304): 1423-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6797568&dopt=Abstract

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Diagnosis of lactose intolerance through the quantification of hydrogen in exhaled air. Author(s): Larracilla-Alegre J, Furuya-Meguro ME, Sotelo-Lopez A, Hernandez-Infante M, Saravia-Herrera JL, Perez-Neria J. Source: Arch Invest Med (Mex). 1981; 12(2): 253-68. English, Spanish. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7271420&dopt=Abstract

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Dietary lactose intake, lactose intolerance, and the risk of epithelial ovarian cancer in southern Ontario (Canada). Author(s): Risch HA, Jain M, Marrett LD, Howe GR. Source: Cancer Causes & Control : Ccc. 1994 November; 5(6): 540-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7827241&dopt=Abstract

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Dietary management of lactose intolerance--lactase treated milk versus soya milk. Author(s): Gupta R, Gupta S. Source: Indian Journal of Medical Sciences. 1993 January; 47(1): 1-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8514340&dopt=Abstract

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Dietary treatment of lactose intolerance in infants and children. Author(s): Sinden AA, Sutphen JL. Source: Journal of the American Dietetic Association. 1991 December; 91(12): 1567-71. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1960350&dopt=Abstract

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Diets in lactose intolerance. Author(s): Skala I, Lamacova V. Source: Nutr Metab. 1971; 13(3): 200-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5171495&dopt=Abstract

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Does lactose intolerance predispose to low bone density? A population-based study of perimenopausal Finnish women. Author(s): Honkanen R, Pulkkinen P, Jarvinen R, Kroger H, Lindstedt K, Tuppurainen M, Uusitupa M. Source: Bone. 1996 July; 19(1): 23-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8830983&dopt=Abstract

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Double blind study of milk lactose intolerance in a group of rural and urban children. Author(s): Lisker R, Aguilar L, Lares I, Cravioto J. Source: The American Journal of Clinical Nutrition. 1980 May; 33(5): 1049-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6892751&dopt=Abstract

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Double blind study of milk lactose intolerance. Author(s): Lisker R, Aguilar L. Source: Gastroenterology. 1978 June; 74(6): 1283-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=348553&dopt=Abstract

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Ear dermatitis, lactose intolerance, and eczema. Author(s): Kirschenbaum MB. Source: Archives of Dermatology. 1981 September; 117(9): 523. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7294841&dopt=Abstract

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Effects of milk viscosity on gastric emptying and lactose intolerance in lactose maldigesters. Author(s): Vesa TH, Marteau PR, Briet FB, Flourie B, Briend A, Rambaud JC. Source: The American Journal of Clinical Nutrition. 1997 July; 66(1): 123-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9209179&dopt=Abstract

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Efficacy of traditional rice-lentil-yogurt diet, lactose free milk protein-based formula and soy protein formula in management of secondary lactose intolerance with acute childhood diarrhoea. Author(s): Nizami SQ, Bhutta ZA, Molla AM. Source: Journal of Tropical Pediatrics. 1996 June; 42(3): 133-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8699577&dopt=Abstract

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Familial aquagenic urticaria associated with familial lactose intolerance. Author(s): Treudler R, Tebbe B, Steinhoff M, Orfanos CE. Source: Journal of the American Academy of Dermatology. 2002 October; 47(4): 611-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12271310&dopt=Abstract

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Fermentation, fermented foods and lactose intolerance. Author(s): Solomons NW. Source: European Journal of Clinical Nutrition. 2002 December; 56 Suppl 4: S50-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12556948&dopt=Abstract

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Flutamide-induced diarrhea secondary to lactose intolerance. Author(s): Yagoda A. Source: Journal of the National Cancer Institute. 1989 December 6; 81(23): 1839-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2585531&dopt=Abstract

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Folate therapy in acquired lactose intolerance diarrhoea. Author(s): Gupta R, Gupta S. Source: Indian Journal of Medical Sciences. 1993 May; 47(5): 147. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8225457&dopt=Abstract

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Functional response of the digestive tract to the ingestion of milk in subjects suffering from lactose intolerance. Author(s): Pirk F, Skala I. Source: Digestion. 1972; 5(2): 89-99. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5066639&dopt=Abstract

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Gene therapy for lactose intolerance. Author(s): Freeman HJ. Source: Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie. 1999 April; 13(3): 209-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10331929&dopt=Abstract

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Genetic aetiology of lactose intolerance. Author(s): Ferguson A, Maxwell JD. Source: Lancet. 1967 July 22; 2(7508): 188-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4165709&dopt=Abstract

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Hydrogen concentration in expired air analyzed with a new hydrogen sensor, plasma glucose rise, and symptoms of lactose intolerance after oral administration of 100 gram lactose. Author(s): Berg A, Eriksson M, Barany F, Einarsson K, Sundgren H, Nylander C, Lundstrom I, Blomstrand R. Source: Scandinavian Journal of Gastroenterology. 1985 September; 20(7): 814-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4048833&dopt=Abstract

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Improved clinical tolerance to chronic lactose ingestion in subjects with lactose intolerance: a placebo effect? Author(s): Briet F, Pochart P, Marteau P, Flourie B, Arrigoni E, Rambaud JC. Source: Gut. 1997 November; 41(5): 632-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9414969&dopt=Abstract

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Incidence and aetiology of lactose intolerance. Author(s): Bryant GD, Chu YK, Lovitt R. Source: The Medical Journal of Australia. 1970 June 27; 1(26): 1285-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5468465&dopt=Abstract

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Incidence of lactose intolerance in Kashmir. Author(s): Malik GM, Khuroo MS, Ahmed SZ. Source: J Assoc Physicians India. 1977 September; 25(9): 623-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=580613&dopt=Abstract

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Infantile colic and lactose intolerance. Author(s): Barr RG. Source: The Journal of Pediatrics. 1989 September; 115(3): 501-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2769515&dopt=Abstract

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Influence of lactose intolerance on the bones of patients after partial gastrectomy. Author(s): Kocian J, Vulterinova M, Bejblova O, Skaala I. Source: Digestion. 1973; 8(4): 324-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4793120&dopt=Abstract

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Intestinal disaccharidase activity in an infant with lactose intolerance. Author(s): Arashima S, Matsuda I, Sato N, Yoshioka H. Source: Helv Paediatr Acta. 1971 June; 26(2): 215-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5139248&dopt=Abstract

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Intestinal lactase deficiency and lactose intolerance in adults. Author(s): Kern F Jr, Struthers JE Jr. Source: Jama : the Journal of the American Medical Association. 1966 March 14; 195(11): 927-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5951966&dopt=Abstract

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Intestinal lactase deficiency and lactose intolerance in adults. Preliminary report. Author(s): Dahlqvist A, Hammond JB, Crane RK, Dunphy JV, Littman A. Source: Gastroenterology. 1968 April; 54(4): Suppl: 807-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5653805&dopt=Abstract

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Intestinal-transit and lactose intolerance in chronic alcoholics. Author(s): Keshavarzian A, Iber FL, Dangleis MD, Cornish R. Source: The American Journal of Clinical Nutrition. 1986 July; 44(1): 70-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3728351&dopt=Abstract

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Irritable bowel syndrome: is the search for lactose intolerance justified? Author(s): Parker TJ, Woolner JT, Prevost AT, Tuffnell Q, Shorthouse M, Hunter JO. Source: European Journal of Gastroenterology & Hepatology. 2001 March; 13(3): 219-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11293439&dopt=Abstract

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Irritable colon syndrome and lactose intolerance. Author(s): Davis AE. Source: Aust N Z J Med. 1971 November; 1(4): 420-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5293004&dopt=Abstract

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Irritable-bowel syndrome with lactose intolerance. Author(s): Ahmed HF. Source: Lancet. 1975 August 16; 2(7929): 319-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=50523&dopt=Abstract

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Is lactose intolerance implicated in the development of post-infectious irritable bowel syndrome or functional diarrhoea in previously asymptomatic people? Author(s): Parry SD, Barton JR, Welfare MR. Source: European Journal of Gastroenterology & Hepatology. 2002 November; 14(11): 1225-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12439117&dopt=Abstract

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Lactose intolerance (LI) predisposes to reduced perimenopausal BMD. Author(s): Devogelaer JP, Faille I, Mainguet P. Source: Bone. 1997 February; 20(2): 175. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9028543&dopt=Abstract

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Lactose intolerance among healthy adults. Author(s): Surjone A, Sebodo T, Sunarto J, Moenginah PA. Source: Paediatr Indones. 1973 February; 13(2): 49-54. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4801754&dopt=Abstract

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Lactose intolerance among Mexican Americans. Author(s): Sowers MF, Winterfeldt E. Source: The American Journal of Clinical Nutrition. 1975 July; 28(7): 704-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1146721&dopt=Abstract

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Lactose intolerance and bone mass in postmenopausal Italian women. Author(s): Corazza GR, Benati G, Di Sario A, Tarozzi C, Strocchi A, Passeri M, Gasbarrini G. Source: The British Journal of Nutrition. 1995 March; 73(3): 479-87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7766570&dopt=Abstract

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Lactose intolerance and diarrhea: are they related? Author(s): Angelides AG, Davidson M. Source: Pediatric Annals. 1985 January; 14(1): 62-3, 66-7, 70-1 Passim. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3838379&dopt=Abstract

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Lactose intolerance and fermented dairy products. Author(s): Gallagher CR, Molleson AL, Caldwell JH. Source: Journal of the American Dietetic Association. 1974 October; 65(4): 418-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4479557&dopt=Abstract

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Lactose intolerance and intestinal villi morphology in Thai people. Author(s): Thong-Ngam D, Suwangool P, Prempracha J, Tangkijvanich P, Vivatvekin B, Sriratanabun A. Source: J Med Assoc Thai. 2001 August; 84(8): 1090-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11758841&dopt=Abstract

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Lactose intolerance and irritable bowel syndrome. Author(s): Turnbull GK. Source: Nutrition (Burbank, Los Angeles County, Calif.). 2000 July-August; 16(7-8): 6656. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10906590&dopt=Abstract

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Lactose intolerance and irritable bowel syndrome. Author(s): Mascolo R, Saltzman JR. Source: Nutrition Reviews. 1998 October; 56(10): 306-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9810810&dopt=Abstract

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Lactose intolerance and lactase deficiency in children. Author(s): Rings EH, Grand RJ, Buller HA. Source: Current Opinion in Pediatrics. 1994 October; 6(5): 562-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7820203&dopt=Abstract

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Lactose intolerance and milk consumption: the relation of tolerance to symptoms. Author(s): Stephenson LS, Latham MC. Source: The American Journal of Clinical Nutrition. 1974 March; 27(3): 296-303. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4405996&dopt=Abstract

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Lactose intolerance and milk drinking habits. Author(s): Bayless TM, Paige DM, Ferry GD. Source: Gastroenterology. 1971 April; 60(4): 605-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5108166&dopt=Abstract

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Lactose intolerance and neuromuscular symptoms. Author(s): Chaudhuri A. Source: Lancet. 2000 August 5; 356(9228): 510-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10981918&dopt=Abstract

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Lactose intolerance and osteoporosis in men. Author(s): Laroche M, Bon E, Moulinier L, Cantagrel A, Mazieres B. Source: Rev Rhum Engl Ed. 1995 December; 62(11): 766-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8869218&dopt=Abstract

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Lactose intolerance and protein malnutrition. Author(s): Dahlqvist A, Lindquist B. Source: Acta Paediatr Scand. 1971 July; 60(4): 488-94. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4933734&dopt=Abstract

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Lactose intolerance and self-reported milk intolerance: relationship with lactose maldigestion and nutrient intake. Lactase Deficiency Study Group. Author(s): Carroccio A, Montalto G, Cavera G, Notarbatolo A. Source: Journal of the American College of Nutrition. 1998 December; 17(6): 631-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9853544&dopt=Abstract

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Lactose intolerance and the genetic regulation of intestinal lactase-phlorizin hydrolase. Author(s): Montgomery RK, Buller HA, Rings EH, Grand RJ. Source: The Faseb Journal : Official Publication of the Federation of American Societies for Experimental Biology. 1991 October; 5(13): 2824-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1916106&dopt=Abstract

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Lactose intolerance and yoghurt. Author(s): Brand JC. Source: Lancet. 1980 February 16; 1(8164): 368. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6101822&dopt=Abstract

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Lactose intolerance and yoghurt. Author(s): McLaughlin M. Source: Lancet. 1980 February 16; 1(8164): 367. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6101818&dopt=Abstract

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Lactose intolerance associated with cataracts. Author(s): Hirashima Y, Shinozuka S, Ieiri T, Matsuda I, Ono Y, Murata T. Source: European Journal of Pediatrics. 1979 January 18; 130(1): 41-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=759181&dopt=Abstract

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Lactose intolerance associated with fractures of weight-bearing bones in Finnish women aged 38-57 years. Author(s): Honkanen R, Kroger H, Alhava E, Turpeinen P, Tuppurainen M, Saarikoski S. Source: Bone. 1997 December; 21(6): 473-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9430235&dopt=Abstract

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Lactose intolerance associated with Intal capsules. Author(s): Brandstetter RD, Conetta R, Glazer B. Source: The New England Journal of Medicine. 1986 December 18; 315(25): 1613-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3097545&dopt=Abstract

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Lactose intolerance during pregnancy in different Indian communities. Author(s): Tandon RK, Goel U, Mukherjee SN, Pandey SC, Lal K. Source: The Indian Journal of Medical Research. 1977 July; 66(1): 33-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=924581&dopt=Abstract

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Lactose intolerance during pregnancy: significance and solutions. Author(s): Luke B. Source: Mcn. the American Journal of Maternal Child Nursing. 1977 March-April; 2(2): 93-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=402536&dopt=Abstract

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Lactose intolerance following antithyroid drug medications. Author(s): Petrini L, Usai P, Caradonna A, Cabula R, Mariotti S. Source: J Endocrinol Invest. 1997 October; 20(9): 569-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9413813&dopt=Abstract

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Lactose intolerance following extensive small intestinal resection. Author(s): Richards AJ, Condon JR, Mallinson CN. Source: The British Journal of Surgery. 1971 July; 58(7): 493-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5089958&dopt=Abstract

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Lactose intolerance following measles. Author(s): Carpentier G, D'Hondt F, Molla AM, Eggermont E. Source: Lancet. 1970 October 3; 2(7675): 725-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4195965&dopt=Abstract

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Lactose intolerance how widespread? Author(s): Kowalski R. Source: Nurs Care. 1977 May; 10(5): 30, 4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=585004&dopt=Abstract

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Lactose intolerance in active Crohn's disease: clinical value of duodenal lactase analysis. Author(s): von Tirpitz C, Kohn C, Steinkamp M, Geerling I, Maier V, Moller P, Adler G, Reinshagen M. Source: Journal of Clinical Gastroenterology. 2002 January; 34(1): 49-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11743245&dopt=Abstract

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Lactose intolerance in adults with chronic unspecific abdominal complaints. Author(s): Bianchi Porro G, Parente F, Sangaletti O. Source: Hepatogastroenterology. 1983 December; 30(6): 254-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6676146&dopt=Abstract

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Lactose intolerance in adults. Author(s): Gupta PS, Misra RC, Ramachandran KA, Chuttani HK. Source: J Assoc Physicians India. 1970 September; 18(9): 765-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5537122&dopt=Abstract

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Lactose intolerance in Alaskan Indians and Eskimos. Author(s): Duncan IW, Scott EM. Source: The American Journal of Clinical Nutrition. 1972 September; 25(9): 867-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5068580&dopt=Abstract

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Lactose intolerance in Arabs. Author(s): Rotthauwe HW, el-Schallah MO, Flatz G. Source: Humangenetik. 1971; 13(4): 344-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5135853&dopt=Abstract

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Lactose intolerance in Asian children. Author(s): Mcveagh P. Source: Journal of Paediatrics and Child Health. 1995 December; 31(6): 564-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8924317&dopt=Abstract

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Lactose intolerance in Asian children. Author(s): Quak SH. Source: Journal of Paediatrics and Child Health. 1994 April; 30(2): 91-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8198862&dopt=Abstract

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Lactose intolerance in Asians. Author(s): Alford SC. Source: Nature. 1969 February 8; 221(180): 562-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5789305&dopt=Abstract

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Lactose intolerance in Asians. Author(s): Davis AE, Bolin TD. Source: Gut. 1969 January; 10(1): 78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5784169&dopt=Abstract

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Lactose intolerance in asians. Author(s): Davis AE, Bolin T. Source: Nature. 1967 December 23; 216(121): 1244-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6076083&dopt=Abstract

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Lactose intolerance in Australia. Author(s): Bolin TD, Morrison RM, Steel JE, Davis AE. Source: The Medical Journal of Australia. 1970 June 27; 1(26): 1289-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5449513&dopt=Abstract

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Lactose intolerance in Australian-born Chinese. Author(s): Bolin TD, Davis AE. Source: Australas Ann Med. 1970 February; 19(1): 40-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5505520&dopt=Abstract

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Lactose intolerance in Canadian West Coast Indians. Author(s): Leichter J, Lee M. Source: Am J Dig Dis. 1971 September; 16(9): 809-13. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5110009&dopt=Abstract

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Lactose intolerance in childhood coeliac disease. Assessment of its incidence and importance. Author(s): McNeish AS, Sweet EM. Source: Archives of Disease in Childhood. 1968 August; 43(230): 433-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5666679&dopt=Abstract

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Lactose intolerance in childhood. Author(s): Bhutta ZA. Source: J Pak Med Assoc. 1996 October; 46(10): 216-7. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8961704&dopt=Abstract

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Lactose intolerance in children with protein-energy malnutrition. Author(s): Verma M, Saxena S. Source: Indian J Pediatr. 1980 July-August; 47(387): 273-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6785220&dopt=Abstract

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Lactose intolerance in chronic diarrhea among Indonesian children. Author(s): Sunoto, Suharjono, Mangiwa J, Sutedjo. Source: Paediatr Indones. 1971 September-October; 11(5): 1-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5158604&dopt=Abstract

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Lactose intolerance in different types of irritable bowel syndrome in north Indians. Author(s): Am Fam Physician. 2002 May 1;65(9):1855-6 Source: Trop Gastroenterol. 2001 October-December; 22(4): 202-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12018808

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Lactose intolerance in East Indians of Trinidad. Author(s): Bartholomew C, Pong OY. Source: Trop Geogr Med. 1976 December; 28(4): 336-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1014074&dopt=Abstract

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Lactose intolerance in Greeks. Author(s): Doxiadis S, Papageorgiadis G. Source: Lancet. 1973 February 3; 1(7797): 271. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4119424&dopt=Abstract

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Lactose intolerance in Greeks. Author(s): Spanidou EP, Petrakis NL. Source: Lancet. 1972 October 21; 2(7782): 872-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4116572&dopt=Abstract

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Lactose intolerance in healthy children. Author(s): Huang SS, Bayless TM. Source: The New England Journal of Medicine. 1967 June 8; 276(23): 1283-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6024348&dopt=Abstract

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Lactose intolerance in idiopathic ulcerative colitis in north Indians. Author(s): Kochhar R, Mehta SK, Goenka MK, Mukherjee JJ, Rana SV, Gupta D. Source: The Indian Journal of Medical Research. 1993 April; 98: 79-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8344736&dopt=Abstract

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Lactose intolerance in infancy as a cuase for failure to thrive. Author(s): Seriki O, Adcock KJ. Source: West Afr Med J Niger Pract. 1968 February; 17(1): 14-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5641292&dopt=Abstract

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Lactose intolerance in Iran. Author(s): Sadre M, Karbasi K. Source: The American Journal of Clinical Nutrition. 1979 September; 32(9): 1948-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=474484&dopt=Abstract

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Lactose intolerance in Jewish patients with ulcerative colitis. Author(s): Tandon R, Mandell H, Spiro HM, Thayer WR Jr. Source: Am J Dig Dis. 1971 September; 16(9): 845-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5098211&dopt=Abstract

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Lactose intolerance in Kenya. Author(s): Luyken R, Luyken-Koning FW. Source: The Proceedings of the Nutrition Society. 1972 May; 31(1): 6A. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5068161&dopt=Abstract

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Lactose intolerance in Nagaland. Author(s): Kar P, Tandon RK. Source: The Indian Journal of Medical Research. 1985 September; 82: 254-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4077166&dopt=Abstract

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Lactose intolerance in Nigerian children. Author(s): Olatunbosun DA, Adadevoh BK. Source: Acta Paediatr Scand. 1972 November; 61(6): 715-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4677999&dopt=Abstract

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Lactose intolerance in North and South Indians. Author(s): Tandon RK, Joshi YK, Singh DS, Narendranathan M, Balakrishnan V, Lal K. Source: The American Journal of Clinical Nutrition. 1981 May; 34(5): 943-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7234720&dopt=Abstract

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Lactose intolerance in pateints with gastroenteritis between 0--2 years of age. Author(s): Mustadjab I, Munir M. Source: Paediatr Indones. 1976 November-December; 16(11-12): 415-29. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=800247&dopt=Abstract

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Lactose intolerance in persistent diarrhoea during childhood: the role of a traditional rice-lentil (Khitchri) and yogurt diet in nutritional management. Author(s): Bhutta ZA, Nizami SQ, Isani Z. Source: J Pak Med Assoc. 1997 January; 47(1): 20-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9056732&dopt=Abstract

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Lactose intolerance in Peruvian children: effect of age and early nutrition. Author(s): Paige DM, Leonardo E, Cordano A, Nakashima J, Adrianzen B, Graham GG. Source: The American Journal of Clinical Nutrition. 1972 March; 25(3): 297-301. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5066943&dopt=Abstract

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Lactose intolerance in protein-energy malnutrition: a clinical case study and family study using a hydrogen (H2) breath-analysis test for carbohydrate malabsorption. Author(s): Solomons NW, Garcia-Ibanez R, Aycinena P, Torun B, Viteri FE. Source: Arquivos De Gastroenterologia. 1979 July-September; 16(3): 137-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=583560&dopt=Abstract

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Lactose intolerance in Singapore. Author(s): Bolin TD, Davis AE, Seah CS, Chua KL, Yong V, Kho KM, Siak CL, Jacob E. Source: Gastroenterology. 1970 July; 59(1): 76-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5468089&dopt=Abstract

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Lactose intolerance in South American Indians. Author(s): Alzate H, Gonzalez H, Guzman J. Source: The American Journal of Clinical Nutrition. 1969 February; 22(2): 122-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5818372&dopt=Abstract

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Lactose intolerance in Surinam. Author(s): Luyken R, Luyken-Koning FW, Immikhuizen MJ. Source: Trop Geogr Med. 1971 March; 23(1): 54-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5108297&dopt=Abstract

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Lactose intolerance in Thailand. Author(s): Flatz G, Saengudom C, Sanguanbhokhai T. Source: Nature. 1969 February 22; 221(182): 758-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5818369&dopt=Abstract

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Lactose intolerance in the adolescent. Author(s): Bayless TM. Source: J Adolesc Health Care. 1982 August; 3(1): 65-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6811535&dopt=Abstract

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Lactose intolerance in the adult. Author(s): Basford RL, Henry JB. Source: Postgraduate Medicine. 1967 January; 41(1): A70-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6036215&dopt=Abstract

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Lactose intolerance in the Koreans. Author(s): Bahk YW, Ahn GS. Source: Mod Med Asia. 1977 March; 13(3): 7-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=579432&dopt=Abstract

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Lactose intolerance in the Lebanese population and in “Mediterranean lymphoma”. Author(s): Nasrallah SM. Source: The American Journal of Clinical Nutrition. 1979 October; 32(10): 1994-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=484518&dopt=Abstract

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Lactose intolerance in Turkey. Author(s): Tuncbilek E, Turun R, Say B. Source: Lancet. 1973 July 21; 2(7821): 151. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4124070&dopt=Abstract

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Lactose intolerance in various ethnic groups in South-East Asia. Author(s): Bolin TD, Crane GG, Davis AE. Source: Australas Ann Med. 1968 November; 17(4): 300-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5701921&dopt=Abstract

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Lactose intolerance in young children and their parents. Author(s): Jones DV, Latham MC. Source: The American Journal of Clinical Nutrition. 1974 June; 27(6): 547-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4406602&dopt=Abstract

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Lactose intolerance syndrome mimicking milk--allergy and/or functional bowel disorders: four cases. Author(s): Horton GE, Wruble LD. Source: Ann Allergy. 1966 December; 24(12): 698-704. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5953598&dopt=Abstract

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Lactose intolerance with lactosuria. Author(s): Kline AH, Assemi M. Source: Tex Med. 1968 July; 64(7): 36-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5662234&dopt=Abstract

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Lactose intolerance, a cause of recurrent diarrhea in Kuwait. Author(s): Mokhtar NA, Ghaly IM. Source: Gaz Egypt Paediatr Assoc. 1974 April; 22(2): 113-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4452452&dopt=Abstract

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Lactose intolerance, calcium intake, and osteopenia. Author(s): Mainguet P, Faille I, Destrebecq L, Devogelaer JP, Nagant de Deuxchaisnes C. Source: Lancet. 1991 November 2; 338(8775): 1156-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1682584&dopt=Abstract

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Lactose intolerance, detected by the hydrogen breath test, in infants and children with chronic diarrhoea. Author(s): Maffei HV, Metz G, Bampoe V, Shiner M, Herman S, Brook CG. Source: Archives of Disease in Childhood. 1977 October; 52(10): 766-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=931422&dopt=Abstract

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Lactose intolerance. Author(s): Swagerty DL Jr, Walling AD, Klein RM. Source: American Family Physician. 2002 May 1; 65(9): 1845-50. Review. Erratum In: Am Fam Physician. 2003 March 15; 67(6): 1195. Summary for Patients In: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12018807&dopt=Abstract

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Lactose intolerance. Author(s): Rusynyk RA, Still CD. Source: J Am Osteopath Assoc. 2001 April; 101(4 Suppl Pt 1): S10-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11392211&dopt=Abstract

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Lactose intolerance. Author(s): Vesa TH, Marteau P, Korpela R. Source: Journal of the American College of Nutrition. 2000 April; 19(2 Suppl): 165S-175S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10759141&dopt=Abstract

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Lactose intolerance. Author(s): Lawlor-Smith C, Lawlor-Smith L. Source: Breastfeed Rev. 1998 May; 6(1): 29-30. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9618605&dopt=Abstract

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Lactose intolerance. Author(s): Kearney P, Malone A. Source: Ir Med J. 1996 May-June; 89(3): 84, 86. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8707526&dopt=Abstract

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Lactose intolerance. Author(s): Roberts HJ. Source: The New England Journal of Medicine. 1995 November 16; 333(20): 1359. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7566042&dopt=Abstract

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Lactose intolerance. Author(s): Fenster DL. Source: The New England Journal of Medicine. 1995 November 16; 333(20): 1359. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7566041&dopt=Abstract

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Lactose intolerance. Author(s): Bayless TM, Paige DM, Bedine MS. Source: The New England Journal of Medicine. 1995 November 16; 333(20): 1358-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7566040&dopt=Abstract

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Lactose intolerance. Author(s): Medow MS, Sloan HR. Source: The New England Journal of Medicine. 1995 November 16; 333(20): 1358; Author Reply 1359. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7566039&dopt=Abstract

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Lactose intolerance. Author(s): Malagelada JR. Source: The New England Journal of Medicine. 1995 July 6; 333(1): 53-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7776997&dopt=Abstract

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Lactose intolerance. Author(s): Castiglia PT. Source: Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners. 1994 January-February; 8(1): 36-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8120780&dopt=Abstract

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Lactose intolerance. Author(s): Buller HA, Grand RJ. Source: Annual Review of Medicine. 1990; 41: 141-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2109963&dopt=Abstract

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Lactose intolerance. Author(s): Kocian J. Source: Int J Biochem. 1988; 20(1): 1-5. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3277877&dopt=Abstract

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Lactose intolerance. Author(s): Wilson J, Riedel G. Source: Can Nurse. 1984 November; 80(10): 27-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6568851&dopt=Abstract

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Lactose intolerance. Author(s): Lieb J. Source: The New England Journal of Medicine. 1980 January 17; 302(3): 178. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7350454&dopt=Abstract

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Lactose intolerance. Author(s): MacLean WC Jr. Source: The New England Journal of Medicine. 1980 January 17; 302(3): 177-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7350453&dopt=Abstract

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Lactose intolerance. Author(s): Bayless TM, Paige DM. Source: Curr Concepts Nutr. 1979; 8: 79-90. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=118846&dopt=Abstract

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Lactose intolerance. Author(s): Desai AB, Gandhi RA, Vani GB. Source: Indian Pediatrics. 1969 July; 6(7): 457-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5359572&dopt=Abstract

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Lactose intolerance. Author(s): Cline MJ, Williams HE, Smith LH Jr. Source: Calif Med. 1967 October; 107(4): 350-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6062285&dopt=Abstract

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Lactose intolerance. Author(s): Rosenberg FH. Source: The American Journal of Nursing. 1977 May; 77(5): 823-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=585548&dopt=Abstract

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Lactose intolerance. Diagnosis and dietary treatment with milk substitutes. Author(s): Talhouk RS, Abdo RA, Saad A. Source: J Med Liban. 1996; 44(1): 36-40. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8885559&dopt=Abstract

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Lactose intolerance. Pinpointing the source of nonspecific gastrointestinal symptoms. Author(s): Montes RG, Perman JA. Source: Postgraduate Medicine. 1991 June; 89(8): 175-8, 181-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2038590&dopt=Abstract

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Lactose intolerance. Recognizing the link between diet and discomfort. Author(s): Aurisicchio LN, Pitchumoni CS. Source: Postgraduate Medicine. 1994 January; 95(1): 113-6, 119-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8278293&dopt=Abstract

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Lactose intolerance. Strategies for symptom management. Author(s): McMahan S, South C, Crespin S. Source: Adv Nurse Pract. 2002 June; 10(6): 71-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12400367&dopt=Abstract

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Lactose intolerance: a new perspective. Author(s): Franz KB. Source: Journal of the American Dietetic Association. 2000 November; 100(11): 1303. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11103648&dopt=Abstract

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Lactose intolerance: a newly recognized cause of gastrointestinal symptoms seen in the practice of occupational medicine. Author(s): McDonagh TJ. Source: J Occup Med. 1969 February; 11(2): 57-64. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5764368&dopt=Abstract

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Lactose intolerance: a risk factor for reduced bone mineral density and vertebral fractures? Author(s): Kudlacek S, Freudenthaler O, Weissboeck H, Schneider B, Willvonseder R. Source: Journal of Gastroenterology. 2002; 37(12): 1014-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12522532&dopt=Abstract

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Lactose intolerance: a self-fulfilling prophecy leading to osteoporosis? Author(s): Savaiano D. Source: Nutrition Reviews. 2003 June; 61(6 Pt 1): 221-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12903833&dopt=Abstract

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Lactose intolerance: an international problem. Author(s): Kretchmer N, Ransome-Kuti O. Source: Proc Inst Med Chic. 1970 November; 28(6): 213-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5537300&dopt=Abstract

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Lactose intolerance: analysis of underlying factors. Author(s): Vonk RJ, Priebe MG, Koetse HA, Stellaard F, Lenoir-Wijnkoop I, Antoine JM, Zhong Y, Huang CY. Source: European Journal of Clinical Investigation. 2003 January; 33(1): 70-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12492455&dopt=Abstract

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Lactose intolerance: diagnosis and management. Author(s): Patel YT, Minocha A. Source: Compr Ther. 2000 Winter; 26(4): 246-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11126094&dopt=Abstract

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Lactose intolerance: hereditary or acquired? Effect of prolonged milk feeding. Author(s): Chua KL, Seah CS. Source: Singapore Med J. 1973 March; 14(1): 29-33. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4740295&dopt=Abstract

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Lactose intolerance: problems in diagnosis and treatment. Author(s): Shaw AD, Davies GJ. Source: Journal of Clinical Gastroenterology. 1999 April; 28(3): 208-16. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10192605&dopt=Abstract

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Lactose intolerance; physiological, clinical and therapeutic considerations. Author(s): Wagh MG, Ghooi RB, Shetty RK. Source: Indian J Pediatr. 1984 November-December; 51(413): 671-81. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6537405&dopt=Abstract

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Lactose intolerance--a case of bovine revenge? Author(s): Mandell HN. Source: Med Times. 1978 April; 106(4): 71-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=642750&dopt=Abstract

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Lactose intolerance-a confusing clinical diagnosis. Author(s): Peuhkuri K, Vapaatalo H, Korpela R, Teuri U. Source: The American Journal of Clinical Nutrition. 2000 February; 71(2): 600-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10648279&dopt=Abstract

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Lactose intolerance--a review. Author(s): Ransome-Kuti O. Source: Postgraduate Medical Journal. 1977; 53 Suppl 2: 73-87. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=18727&dopt=Abstract

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Lactose malabsorption and lactose intolerance: implications for general milk consumption. Author(s): Torun B, Solomons NW, Viteri FE. Source: Arch Latinoam Nutr. 1979 December; 29(4): 445-94. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=121688&dopt=Abstract

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Lactose malabsorption in Greek adults: correlation of small bowel transit time with the severity of lactose intolerance. Author(s): Ladas S, Papanikos J, Arapakis G. Source: Gut. 1982 November; 23(11): 968-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7129206&dopt=Abstract

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Lactose-free milk as a solution of problems associated with dietetic treatment of lactose intolerance. Author(s): Skala I, Lamacova V, Pirk F. Source: Digestion. 1971; 4(6): 326-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4329889&dopt=Abstract

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Lactose-poor milk in adult lactose intolerance. Author(s): Nagy L, Mozsik G, Garamszegi M, Sasreti E, Ruzsa C, Javor T. Source: Acta Med Hung. 1983; 40(4): 239-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6689533&dopt=Abstract

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Lactosuria in lactose intolerance. Author(s): Gupta BD, Gupta R, Maheshwari JC, Jain A. Source: Indian J Pediatr. 1991 September-October; 58(5): 725-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1813423&dopt=Abstract

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Lactulose in baby milks causing diarrhoea simulating lactose intolerance. Author(s): Hendrickse RG, Wooldridge MA, Russell A. Source: British Medical Journal. 1977 May 7; 1(6070): 1194-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=861533&dopt=Abstract

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Letter: Childhood lactose intolerance. Author(s): Vlachos P, Liakakos D, Boviatsi E. Source: The New England Journal of Medicine. 1976 January 15; 294(3): 163-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1244515&dopt=Abstract

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Letter: Lactose intolerance in San populations. Author(s): Nurse GT, Jenkins T. Source: British Medical Journal. 1974 September 28; 3(5934): 809. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4479190&dopt=Abstract

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Letter: Lactose intolerance in San populations. Author(s): Pettifor JM, Hansen JD. Source: British Medical Journal. 1974 July 20; 3(924): 173. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4407889&dopt=Abstract

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Letter: Lactose intolerance in San populations. Author(s): Nurse GT, Jenkins T. Source: British Medical Journal. 1974 June 29; 2(921): 728. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4852839&dopt=Abstract

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Management of lactose intolerance. Author(s): Tamm A. Source: Scandinavian Journal of Gastroenterology. Supplement. 1994; 202: 55-63. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8042018&dopt=Abstract

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Milk and lactose intolerance following distal small bowel resection. Author(s): Wapnick S. Source: The American Journal of Clinical Nutrition. 1972 July; 25(7): 655-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5067819&dopt=Abstract

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Milk and lactose intolerance in healthy Orientals. Author(s): Huang SS, Bayless TM. Source: Science. 1968 April 5; 160(823): 83-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5694356&dopt=Abstract

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Milk fat does not affect the symptoms of lactose intolerance. Author(s): Vesa TH, Lember M, Korpela R. Source: European Journal of Clinical Nutrition. 1997 September; 51(9): 633-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9306091&dopt=Abstract

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Modified Rubner's test: diagnosis of secondary lactose intolerance diarrhea. Author(s): Gupta BD, Singh R, Arora AK, Agarwal S. Source: Indian Pediatrics. 1992 June; 29(6): 789-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1500151&dopt=Abstract

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Myths & facts. about lactose intolerance. Author(s): McConnell EA. Source: Nursing. 1999 March; 29(3): 71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10205513&dopt=Abstract

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Neonatal campylobacter enteritis with secondary lactose intolerance. Author(s): McShane MA, Gillespie SH, Corkey CW. Source: Acta Paediatr Scand. 1988 July; 77(4): 603. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3394516&dopt=Abstract

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Number of breath samples required for detection of lactose intolerance by lactose hydrogen breath test. Author(s): Rana S, Bhasin DK, Sachdev A, Singh K. Source: Indian J Gastroenterol. 1997 July; 16(3): 118. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9248196&dopt=Abstract

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Nursing caries and lactose intolerance. Author(s): Juambeltz JC, Kula K, Perman J. Source: Asdc J Dent Child. 1993 November-December; 60(4): 377-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8126301&dopt=Abstract

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Osteoporosis and lactose intolerance. Author(s): Devogelaer JP, Mainguet P, Faille I. Source: Rev Rhum Engl Ed. 1996 June; 63(6): 460. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8817761&dopt=Abstract

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Overcoming the barrier of lactose intolerance to reduce health disparities. Author(s): Jarvis JK, Miller GD. Source: Journal of the National Medical Association. 2002 February; 94(2): 55-66. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11853047&dopt=Abstract

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Plasma insulin response to oral lactose and glucose-galactose in patients with lactose intolerance. Author(s): Olatunbosun DA, Adadevoh BK. Source: Ghana Med J. 1973 December; 12(4): 370-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4618960&dopt=Abstract

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Possible therapeutic use of loperamide for symptoms of lactose intolerance. Author(s): Szilagyi A, Torchinsky A, Calacone A. Source: Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie. 2000 July-August; 14(7): 581-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10978944&dopt=Abstract

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Prebiotics or probiotics for lactose intolerance: a question of adaptation. Author(s): Szilagyi A. Source: The American Journal of Clinical Nutrition. 1999 July; 70(1): 105-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10393148&dopt=Abstract

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Pregnancy and lactose intolerance. Author(s): Paige DM, Bayless TM, Graham GG. Source: The American Journal of Clinical Nutrition. 1973 March; 26(3): 238-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4739488&dopt=Abstract

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Prevalence of lactose intolerance in children with recurrent abdominal pain. Author(s): Christensen MF. Source: Archives of Disease in Childhood. 1978 August; 53(8): 693. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=708112&dopt=Abstract

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Prevalence of lactose intolerance in children with recurrent abdominal pain. Author(s): Christensen MF. Source: Pediatrics. 1980 March; 65(3): 681-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7360576&dopt=Abstract

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Primary adult lactose intolerance and the milking habit: a problem in biologic and cultural interrelations. II. A culture historical hypothesis. Author(s): Simoons FJ. Source: Am J Dig Dis. 1970 August; 15(8): 695-710. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5468838&dopt=Abstract

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Primary adult lactose intolerance and the milking habit: a problem in biological and cultural interrelations. I. Review of the medical research. Author(s): Simoons FJ. Source: Am J Dig Dis. 1969 December; 14(12): 819-36. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4902756&dopt=Abstract

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Primary adult lactose intolerance in the Kivu Lake area: Rwanda and the Bushi. Author(s): Cox JA, Elliott FG. Source: Am J Dig Dis. 1974 August; 19(8): 714-24. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4843214&dopt=Abstract

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Primary adult lactose intolerance protects against development of inflammatory bowel disease. Author(s): Nanji AA, Denardi FG. Source: Medical Hypotheses. 1986 January; 19(1): 1-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3634901&dopt=Abstract

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Primary adult lactose malabsorption in Italy: regional differences in prevalence and relationship to lactose intolerance and milk consumption. Author(s): Cavalli-Sforza LT, Strata A, Barone A, Cucurachi L. Source: The American Journal of Clinical Nutrition. 1987 April; 45(4): 748-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3565303&dopt=Abstract

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Primary lactose intolerance in Zulu adults. Author(s): O'Keefe SJ, Adam JK. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1983 May 14; 63(20): 778-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6845098&dopt=Abstract

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Progress report. New light on ethnic differences in adult lactose intolerance. Author(s): Simoons FJ. Source: Am J Dig Dis. 1973 July; 18(7): 595-611. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4717684&dopt=Abstract

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Radiological diagnosis of lactose intolerance in children with chronic diarrhoea. Author(s): Vazquez B, Amador A. Source: Acta Paediatr Acad Sci Hung. 1973; 14(1): 51-61. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4741483&dopt=Abstract

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Recent advances in the management of lactose intolerance. Author(s): Savaiano DA, Kotz C. Source: Bol Asoc Med P R. 1989 May; 81(5): 188-92. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2660841&dopt=Abstract

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Recent advances in the management of lactose intolerance. Author(s): Savaiano DA, Kotz C. Source: Asdc J Dent Child. 1989 May-June; 56(3): 228-33. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2656797&dopt=Abstract

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Recognition of lactose intolerance. Author(s): Bayless TM. Source: Hosp Pract. 1976 October; 11(10): 97-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1037445&dopt=Abstract

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Recurrent abdominal pain and lactose intolerance in childhood. Author(s): Blumenthal I, Kelleher J, Littlewood JM. Source: British Medical Journal (Clinical Research Ed.). 1981 June 20; 282(6281): 2013-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6788173&dopt=Abstract

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Recurrent abdominal pain and lactose intolerance. Author(s): Bianchi Porro G, Petrillo M, Parente F, Sangaletti O, Vedova GD. Source: British Medical Journal (Clinical Research Ed.). 1981 August 15; 283(6289): 501. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6790037&dopt=Abstract

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Recurrent abdominal pain due to milk and lactose intolerance in school-aged children. Author(s): Bayless TM, Huang SS. Source: Pediatrics. 1971 June; 47(6): 1029-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5172188&dopt=Abstract

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Recurrent abdominal pain of childhood due to lactose intolerance. Author(s): Barr RG, Levine MD, Watkins JB. Source: The New England Journal of Medicine. 1979 June 28; 300(26): 1449-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=449886&dopt=Abstract

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Reinvestigation of lactose intolerant children: lack of correlation between continuing lactose intolerance and small intestinal morphology, disaccharidase activity, and lactose tolerance tests. Author(s): Harrison M, Walker-Smith JA. Source: Gut. 1977 January; 18(1): 48-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=838402&dopt=Abstract

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Relationship of lactose intolerance to milk intolerance in young children. Author(s): Garza C, Scrimshaw NS. Source: The American Journal of Clinical Nutrition. 1976 February; 29(2): 192-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=946382&dopt=Abstract

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Relationships between lactase activity and calcium absorption. Lactose intolerance in hyperparathyroidism. Author(s): Nordio S, Berio A, Gatti R, Lamedica GM. Source: Ann Paediatr. 1966; 206(2): 85-96. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5953112&dopt=Abstract

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Relative lactose intolerance. A clinical study of tube-fed patients. Author(s): Walike BC, Walike JW. Source: Jama : the Journal of the American Medical Association. 1977 August 29; 238(9): 948-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=407377&dopt=Abstract

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Respiratory methane excretion in children with lactose intolerance. Author(s): Medow MS, Glassman MS, Schwarz SM, Newman LJ. Source: Digestive Diseases and Sciences. 1993 February; 38(2): 328-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8425445&dopt=Abstract

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Review article: the treatment of lactose intolerance. Author(s): Suarez FL, Savaiano DA, Levitt MD. Source: Alimentary Pharmacology & Therapeutics. 1995 December; 9(6): 589-97. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8824645&dopt=Abstract

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Role of irritable bowel syndrome in subjective lactose intolerance. Author(s): Vesa TH, Seppo LM, Marteau PR, Sahi T, Korpela R. Source: The American Journal of Clinical Nutrition. 1998 April; 67(4): 710-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9537618&dopt=Abstract

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Severe familial lactose intolerance--a gastrogen disorder? Author(s): Berg NO, Dahlqvist A, Lindberg T, Studnitz W. Source: Acta Paediatr Scand. 1969 September; 58(5): 525-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5365173&dopt=Abstract

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Severe lactose intolerance with lactosuria and vomiting. Author(s): Hoskova A, Sabacky J, Mrskos A, Pospisil R. Source: Archives of Disease in Childhood. 1980 April; 55(4): 304-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7416780&dopt=Abstract

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Symptoms of lactose intolerance - forget about the cause? Author(s): Allard JP. Source: Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie. 2000 July-August; 14(7): 573-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10978942&dopt=Abstract

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Test for lactose intolerance. Author(s): Murtagh J. Source: Aust Fam Physician. 1993 July; 22(7): 1272. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8373318&dopt=Abstract

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The acceptability of milk and milk products in populations with a high prevalence of lactose intolerance. Author(s): Scrimshaw NS, Murray EB. Source: The American Journal of Clinical Nutrition. 1988 October; 48(4 Suppl): 1079-159. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3140651&dopt=Abstract

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The clinical significance of lactose intolerance. Author(s): Neaverson MA. Source: Aust Fam Physician. 1980 October; 9(10): 747-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6893545&dopt=Abstract

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The implications of lactose intolerance in children. Author(s): Jones DV, Latham MC. Source: J Trop Pediatr Environ Child Health. 1974 October; 20(5): 261-71. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4615181&dopt=Abstract

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The prevalence of lactase deficiency and lactose intolerance in Chinese children of different ages. Author(s): Yang Y, He M, Cui H, Bian L, Wang Z. Source: Chinese Medical Journal. 2000 December; 113(12): 1129-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11776151&dopt=Abstract

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The relationship between lactose tolerance test results and symptoms of lactose intolerance. Author(s): Hermans MM, Brummer RJ, Ruijgers AM, Stockbrugger RW. Source: The American Journal of Gastroenterology. 1997 June; 92(6): 981-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9177514&dopt=Abstract

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The response to dietary treatment of patients with chronic post-infectious diarrhea and lactose intolerance. Author(s): Lifshitz F, Fagundes-Neto U, Ferreira VC, Cordano A, Ribeiro Hda C. Source: Journal of the American College of Nutrition. 1990 June; 9(3): 231-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2358619&dopt=Abstract

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The role of milk and lactose intolerance in Ethiopian patients with non-ulcer dyspepsia: a case control study. Author(s): Tsega E, Endeshaw Y, Mengesha B, Tedla B. Source: Ethiop Med J. 1989 July; 27(3): 135-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2787744&dopt=Abstract

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The role of radiology in the diagnosis of lactose intolerance in childhood. Author(s): Walker-Smith JA, Bowdler JD. Source: Gut. 1969 January; 10(1): 78-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5784170&dopt=Abstract

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The severity of lactose intolerance in Indonesian children. Author(s): Bakry F, Sunoto, Hendardji H, Suharjono. Source: Paediatr Indones. 1973 July-August; 13(7): 185-90. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4210449&dopt=Abstract

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Tolerance to the daily ingestion of two cups of milk by individuals claiming lactose intolerance. Author(s): Suarez FL, Savaiano D, Arbisi P, Levitt MD. Source: The American Journal of Clinical Nutrition. 1997 May; 65(5): 1502-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9129483&dopt=Abstract

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Transient lactose intolerance in infancy. Author(s): Bartrop RW, Hull D. Source: Archives of Disease in Childhood. 1973 December; 48(12): 963-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4765658&dopt=Abstract

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Transient lactose intolerance in premature infants. Author(s): Abdo-Bassols F, Lifshitz F, Del Castillo ED, Martinez-Garza V. Source: Pediatrics. 1971 November; 48(5): 816-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5121241&dopt=Abstract

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Treatment of lactose intolerance with exogenous beta-D-galactosidase in pellet form. Author(s): Xenos K, Kyroudis S, Anagnostidis A, Papastathopoulos P. Source: Eur J Drug Metab Pharmacokinet. 1998 April-June; 23(2): 350-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9725505&dopt=Abstract

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Vitamin B 12 deficiency in infancy associated with lactose intolerance. Author(s): Choudhry VP. Source: Indian J Pediatr. 1972 August; 39(295): 267-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4644296&dopt=Abstract

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When to suspect lactose intolerance. Symptomatic, ethnic, and laboratory clues. Author(s): Srinivasan R, Minocha A. Source: Postgraduate Medicine. 1998 September; 104(3): 109-11, 115-6, 122-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9742907&dopt=Abstract

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Yogurt could be used for lactose intolerance. Author(s): Ozsoylu S. Source: Archives of Pediatrics & Adolescent Medicine. 1994 November; 148(11): 1231. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7921135&dopt=Abstract

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Zinc deficiency and a synthetic diet for lactose intolerance. Author(s): Moynahan EJ, Barnes PM. Source: Lancet. 1973 March 24; 1(7804): 676-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4121892&dopt=Abstract

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CHAPTER 2. NUTRITION AND LACTOSE INTOLERANCE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and lactose intolerance.

Finding Nutrition Studies on Lactose Intolerance The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “lactose intolerance” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4

Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “lactose intolerance” (or a synonym): •

Lessons in comparative physiology: lactose intolerance. Source: Filer, L.J. Jr. Reynolds, W.A. Nutrition-today (USA). (Mar-April 1997). volume 32(2) page 79-81.

Additional physician-oriented references include: •

Adult-type lactase deficiency. Source: Kwon, T.W. Kim, J.S. Moon, G.S. Song, Y.S. Kim, J.I. Hong, J.H. Nutr-today. Hagerstown, Md. : Lippincott Williams & Wilkins. July/August 2000. volume 35 (4) page 134-141. 0029-666X

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Calcium needs and lactose intolerance. Source: Perman, J.A. Carnat-Nutr-Educ-Ser. New York : Raven Press. 1992. volume 3 page 65-75. 1049-4901

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Can't stomach milk? Keep lactose intolerance at bay. Source: Lepke, J. Environ-nutr. New York : Environmental Nutrition, Inc.,. October 1993. volume 16 (10) page 2. 0893-4452

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Cow's milk allergy versus cow milk intolerance. Author(s): Allergy & Immunology Section, Louisiana State University School of Medicine, Shreveport, Louisiana 71130-3932, USA. [email protected] Source: Bahna, S L Ann-Allergy-Asthma-Immunol. 2002 December; 89(6 Suppl 1): 56-60 1081-1206

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Dietary lactose intake, lactose intolerance, and the risk of epithelial ovarian cancer in southern Ontario (Canada). Author(s): Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06510. Source: Risch, H A Jain, M Marrett, L D Howe, G R Cancer-Causes-Control. 1994 November; 5(6): 540-8 0957-5243

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Dietary management of lactose intolerance--lactase treated milk versus soya milk. Author(s): Department of Pediatrics, Dr. Sampurnanand Medical College, Jodhpur, India. Source: Gupta, R Gupta, S Indian-J-Med-Sci. 1993 January; 47(1): 1-7 0019-5359

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Lactase deficiency. Diagnosis and management. Source: Littman, A Hosp-Pract-(Off-Ed). 1987 January 30; 22(1A): 111-5, 118-20, 123-4 8750-2836

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Lactose intolerance and lactase deficiency in children. Author(s): Academic Medical Center, University of Amsterdam, The Netherlands. Source: Rings, E H Grand, R J Buller, H A Curr-Opin-Pediatr. 1994 October; 6(5): 562-7 1040-8703

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Lactose intolerance. Source: Castiglia, P T J-Pediatr-Health-Care. 1994 Jan-February; 8(1): 36-8 0891-5245

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Marketers milk misconceptions on lactose intolerance. Source: Tufts-Univ-diet-nutr-lett. New York, N.Y. : Tufts University Diet and Nutrition Letter, 1983-c1997. December 1994. volume 12 (10) page 4-7. 0747-4105

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Most frequently asked questions about lactose intolerance. Author(s): Cornell University Medical College.

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Source: Levine, B. Nutrition-today (USA). (April 1996). volume 31(2) page 78-79. digestive disorders symptoms foods children nutrients supplements 0029-666X •

New help for lactose intolerance. Source: Kantor, M.A. Nutr-Forum. Philadelphia, Pa. : George F. Stickley Company. Sept 1986. volume 3 (9) page 71. 0748-8165

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Nutritive value of chicken and corn flour mixtures in formulas for infants with lactose intolerance. Source: Cornejo, L. Hernandez, M. Sotelo, A. Cereal-chem. St. Paul, Minn. : American Association of Cereal Chemists, 1924-. Sept/October 1993. volume 70 (5) page 572-575. 0009-0352

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The prevalence of lactase deficiency and lactose intolerance in Chinese children of different ages. Author(s): Institute of Nutrition and Food Hygiene, Chinese Academy of Preventive Medicine, Beijing 100050, China. Source: Yang, Y He, M Cui, H Bian, L Wang, Z Chin-Med-J-(Engl). 2000 December; 113(12): 1129-32 0366-6999

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When to suspect lactose intolerance. Symptomatic, ethnic, and laboratory clues. Author(s): Department of Medicine, Temple University School of Medicine, Philadelphia, USA. Source: Srinivasan, R Minocha, A Postgrad-Med. 1998 September; 104(3): 109-11, 115-6, 122-3 0032-5481

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

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Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMDHealth: http://my.webmd.com/nutrition

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

The following is a specific Web list relating to lactose intolerance; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Minerals Betaine Hydrochloride Source: Healthnotes, Inc.; www.healthnotes.com Calcium Source: Healthnotes, Inc.; www.healthnotes.com

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Food and Diet Dairy-free Diet Source: Healthnotes, Inc.; www.healthnotes.com Milk Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,95,00.html Yogurt Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,97,00.html

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CHAPTER 3. ALTERNATIVE MEDICINE AND LACTOSE INTOLERANCE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to lactose intolerance. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to lactose intolerance and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “lactose intolerance” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to lactose intolerance: •

A genetic study of lactose digestion in Nigerian families. Author(s): Ransome-Kuti O, Kretchmer N, Johnson JD, Gribble JT. Source: Gastroenterology. 1975 March; 68(3): 431-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1112447&dopt=Abstract

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A soy protein formula and a milk-based formula. A comparative evaluation in milktolerant infants showed no significant nutritional differences. Author(s): Jung AL, Carr SL. Source: Clinical Pediatrics. 1977 November; 16(11): 982-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=578789&dopt=Abstract

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Adverse reactions to food constituents: allergy, intolerance, and autoimmunity. Author(s): Kitts D, Yuan Y, Joneja J, Scott F, Szilagyi A, Amiot J, Zarkadas M.

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Source: Canadian Journal of Physiology and Pharmacology. 1997 April; 75(4): 241-54. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9196849&dopt=Abstract •

Allergy to cow's milk in the first year of life and its prevention. Author(s): Wilson NW, Hamburger RN. Source: Ann Allergy. 1988 November; 61(5): 323-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3056124&dopt=Abstract

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Calcium and bone health in children: a review. Author(s): Stallings VA. Source: American Journal of Therapeutics. 1997 July-August; 4(7-8): 259-73. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10423619&dopt=Abstract

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Causes and prevention of diarrhoea in patients receiving enteral nutritional support. Author(s): Broom J, Jones K. Source: J Hum Nutr. 1981 April; 35(2): 123-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6785345&dopt=Abstract

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Chromium 51-ethylenediaminetetraacetate test: a useful test in the assessment of inflammatory bowel disease. Author(s): O'Morain CA, Abelow AC, Chervu LR, Fleischner GM, Das KM. Source: The Journal of Laboratory and Clinical Medicine. 1986 November; 108(5): 430-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3095471&dopt=Abstract

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Chronic diarrhea and soy formulas. Inhibition of diarrhea by lactose. Author(s): Donovan GK, Torres-Pinedo R. Source: Am J Dis Child. 1987 October; 141(10): 1069-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3630992&dopt=Abstract

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Clinical applications of probiotic agents. Author(s): Saavedra JM. Source: The American Journal of Clinical Nutrition. 2001 June; 73(6): 1147S-1151S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11393193&dopt=Abstract

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Congenital lactase deficiency. A clinical study on 16 patients. Author(s): Savilahti E, Launiala K, Kuitunen P. Source: Archives of Disease in Childhood. 1983 April; 58(4): 246-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6847226&dopt=Abstract

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Cow versus soy formulas. Comparative evaluation in normal infants. Author(s): Cherry FF, Cooper MD, Stewart RA, Platou RV. Source: Am J Dis Child. 1968 June; 115(6): 677-92. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5694767&dopt=Abstract

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Diet in gastrointestinal diseases. Author(s): Manier JW. Source: The Medical Clinics of North America. 1970 November; 54(6): 1357-65. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4321135&dopt=Abstract

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Dietary lactose as a possible risk factor for ischaemic heart disease: review of epidemiology. Author(s): Segall JJ. Source: International Journal of Cardiology. 1994 October; 46(3): 197-207. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7814174&dopt=Abstract

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Dietary management of lactose intolerance--lactase treated milk versus soya milk. Author(s): Gupta R, Gupta S. Source: Indian Journal of Medical Sciences. 1993 January; 47(1): 1-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8514340&dopt=Abstract

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Dietary treatment of lactose intolerance in infants and children. Author(s): Sinden AA, Sutphen JL. Source: Journal of the American Dietetic Association. 1991 December; 91(12): 1567-71. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1960350&dopt=Abstract

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Does low lactose milk powder improve the nutritional intake and nutritional status of frail older Chinese people living in nursing homes? Author(s): Kwok T, Woo J, Kwan M. Source: J Nutr Health Aging. 2001; 5(1): 17-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11250664&dopt=Abstract

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Editorial: Evolution, lactase levels, and global hunger. Author(s): Almy TP. Source: The New England Journal of Medicine. 1975 May 29; 292(22): 1183-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1173193&dopt=Abstract

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Effect of a bulk-forming cathartic on diarrhea in tube-fed patients. Author(s): Heather DJ, Howell L, Montana M, Howell M, Hill R.

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Source: Heart & Lung : the Journal of Critical Care. 1991 July; 20(4): 409-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1906447&dopt=Abstract •

Effect of a vegetable-protein-rich polymeric diet treatment on body composition and energy metabolism in inactive Crohn's disease. Author(s): Capristo E, Mingrone G, Addolorato G, Greco AV, Gasbarrini G. Source: European Journal of Gastroenterology & Hepatology. 2000 January; 12(1): 5-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10656203&dopt=Abstract

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Effect of fiber on breath hydrogen response and symptoms after oral lactose in lactose malabsorbers. Author(s): Nguyen KN, Welsh JD, Manion CV, Ficken VJ. Source: The American Journal of Clinical Nutrition. 1982 June; 35(6): 1347-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6282106&dopt=Abstract

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Effect of lactic acid bacteria on diarrheal diseases. Author(s): Heyman M. Source: Journal of the American College of Nutrition. 2000 April; 19(2 Suppl): 137S-146S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10759139&dopt=Abstract

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Effective reduction of lactose maldigestion in preschool children by direct addition of beta-galactosidases to milk at mealtime. Author(s): Barillas C, Solomons NW. Source: Pediatrics. 1987 May; 79(5): 766-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3106927&dopt=Abstract

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Effects of formula change on intestinal hydrogen production and crying and fussing behavior. Author(s): Barr RG, Wooldridge J, Hanley J. Source: Journal of Developmental and Behavioral Pediatrics : Jdbp. 1991 August; 12(4): 248-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1939680&dopt=Abstract

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Efficacy of traditional rice-lentil-yogurt diet, lactose free milk protein-based formula and soy protein formula in management of secondary lactose intolerance with acute childhood diarrhoea. Author(s): Nizami SQ, Bhutta ZA, Molla AM. Source: Journal of Tropical Pediatrics. 1996 June; 42(3): 133-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8699577&dopt=Abstract

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Environmental influences on lactose tolerance. Author(s): Johnson RC, Ayau EP, Ching CA, Nagoshi CT, Yuen S, Huang YH, Fjelstad K. Source: Behavior Genetics. 1987 July; 17(4): 313-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3675524&dopt=Abstract

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Ethnic diets in a Western world. Author(s): Freeman A. Source: J Fam Health Care. 2002; 12(2 Suppl): 3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12415757&dopt=Abstract

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Lactase deficiency in the South African black population. Author(s): Segal I, Gagjee PP, Essop AR, Noormohamed AM. Source: The American Journal of Clinical Nutrition. 1983 December; 38(6): 901-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6650448&dopt=Abstract

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Lactose intolerance in persistent diarrhoea during childhood: the role of a traditional rice-lentil (Khitchri) and yogurt diet in nutritional management. Author(s): Bhutta ZA, Nizami SQ, Isani Z. Source: J Pak Med Assoc. 1997 January; 47(1): 20-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9056732&dopt=Abstract

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Nursing caries and lactose intolerance. Author(s): Juambeltz JC, Kula K, Perman J. Source: Asdc J Dent Child. 1993 November-December; 60(4): 377-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8126301&dopt=Abstract

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Prebiotics or probiotics for lactose intolerance: a question of adaptation. Author(s): Szilagyi A. Source: The American Journal of Clinical Nutrition. 1999 July; 70(1): 105-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10393148&dopt=Abstract

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Primary adult lactose intolerance and the milking habit: a problem in biologic and cultural interrelations. II. A culture historical hypothesis. Author(s): Simoons FJ. Source: Am J Dig Dis. 1970 August; 15(8): 695-710. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5468838&dopt=Abstract

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Primary adult lactose intolerance and the milking habit: a problem in biological and cultural interrelations. I. Review of the medical research. Author(s): Simoons FJ.

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Source: Am J Dig Dis. 1969 December; 14(12): 819-36. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4902756&dopt=Abstract •

Soy protein intolerance: four patients with concomitant cow's milk intolerance. Author(s): Whitington PF, Gibson R. Source: Pediatrics. 1977 May; 59(5): 730-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=558576&dopt=Abstract

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The response to dietary treatment of patients with chronic post-infectious diarrhea and lactose intolerance. Author(s): Lifshitz F, Fagundes-Neto U, Ferreira VC, Cordano A, Ribeiro Hda C. Source: Journal of the American College of Nutrition. 1990 June; 9(3): 231-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2358619&dopt=Abstract

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Wheat extract and milk mixture as a milk substitute for children with milk intolerance. Author(s): Suthutvoravut U, Tontisirin K, Varavithya W, Valyasevi A, Bjorck I, Dahlqvist A. Source: J Diarrhoeal Dis Res. 1984 September; 2(3): 168-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6512217&dopt=Abstract

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

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Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMDHealth: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

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The following is a specific Web list relating to lactose intolerance; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Allergies and Sensitivities Source: Healthnotes, Inc.; www.healthnotes.com Celiac Disease Source: Healthnotes, Inc.; www.healthnotes.com Diarrhea Source: Healthnotes, Inc.; www.healthnotes.com Gastroesophageal Reflux Disease Source: Healthnotes, Inc.; www.healthnotes.com Lactose Intolerance Source: Healthnotes, Inc.; www.healthnotes.com Lactose Intolerance Source: Integrative Medicine Communications; www.drkoop.com Malabsorption Source: Healthnotes, Inc.; www.healthnotes.com Migraine Headaches Source: Healthnotes, Inc.; www.healthnotes.com

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Herbs and Supplements Digestive Enzymes Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10051,00.html L. Acidophilus Source: Integrative Medicine Communications; www.drkoop.com Lactase Source: Healthnotes, Inc.; www.healthnotes.com Lactobacillus Acidophilus Source: Integrative Medicine Communications; www.drkoop.com Metoclopramide Source: Healthnotes, Inc.; www.healthnotes.com

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General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. PATENTS ON LACTOSE INTOLERANCE Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.5 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “lactose intolerance” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on lactose intolerance, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Lactose Intolerance By performing a patent search focusing on lactose intolerance, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. 5Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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The following is an example of the type of information that you can expect to obtain from a patent search on lactose intolerance: •

Novel lactase Inventor(s): Iida; Takao (Shiga, JP), Kotaka; Toshihiko (Otsu, JP), Ozaki; Sho (Shiga, JP) Assignee(s): Daiwa Kasei Kabushiki Kaisha (Osaka, JP) Patent Number: 4,237,230 Date filed: June 26, 1979 Abstract: A novel lactase having a molecular weight of about 3.times.10.sup.5, an optimum pH value of about 6.0, an optimum temperature of about 60.degree. C. and at least 1 of the ratio of the activity for hydrolyzing lactose to the activity for hydrolyzing a synthetic substrate: o-nitrophenyl-.beta.-D-galactopyranoside (Lact/ONPG ratio), which is produced by cultivating a microorganism of the genus Bacillus being capable of producing the enzyme, particularly Bacillus circulans LOB 377 (ATCC No. 31382) and isolating from the culture broth. This novel lactase is characteristic in the excellent thermostability and the high Lact/ONPG ratio and hence is useful for treating milk and milk products as well as for preventing diarrhea due to lactose intolerance, especially in babies and infants. Excerpt(s): The present invention relates to a novel lactase having an excellent thermostability and a method for the production thereof. More particularly, it relates to a novel lactase having an excellent thermostability and high activity for hydrolyzing lactose, which is produced by cultivating a microorganism of the genus Bacillus being capable of producing the novel lactase. (1) The most of the known lactases do not show a really high activity for hydrolyzing lactose. The activity of lactase is usually shown by the activity for hydrolyzing a synthetic substrate: o-nitrophenyl-.beta.-Dgalactopyranoside (hereinafter, referred to as "ONPG"), because it can easily be measured. However, the hydrolyzing activity against the synthetic substrate does not necessarily coincide with the activity against the real substrate: lactose, and known lactases have a ratio of the lactose-hydrolyzing activity to the ONPG-hydrolyzing activity (hereinafter, referred to as "Lact/ONPG ratio") of far smaller than 1. (2) For the purpose of treating milk and milk products, the lactase should have an optimum pH value around neutral and a higher optimum temperature in view of raising the reaction rate and of preventing putrefaction of the milk and milk products, but most known lactases do not satisfy both conditions. Web site: http://www.delphion.com/details?pn=US04237230__

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Secretin and secretin pharmaceuticals for treating lactose intolerance Inventor(s): Rogoff; Joseph A. (12812 Panorama View, Santa Ana, CA 92705), Warner; F. Jack (442 Pebble Beach Pl., Fullerton, CA 92835) Assignee(s): none reported Patent Number: 6,599,882 Date filed: November 3, 2000 Abstract: A method for treating lactose intolerance wherein the hormone secretin, or an acceptable pharmaceutical synthetic thereof, is administered to a person suffering from lactose intolerance. Patients so treated exhibit greatly improved digestion of lactose.

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Excerpt(s): The invention relates to a pharmaceutical and a method for treating lactose intolerance. More particularly, the invention relates to the use of the hormone secretin, or an acceptable pharmaceutical synthetic thereof, in the treatment of lactose intolerance. Lactose intolerance is the inability to properly digest lactose, the predominant sugar of milk. Lactose is also known as milk sugar. Symptoms of lactose intolerance include abdominal bloating, gaseousness, cramping and diarrhea following the consumption of food containing dairy products or by-products (such as whey). Lactose is a disaccharide composed of glucose and galactose. People who are lactose intolerant do not produce enough lactase, an enzyme normally produced by the epithelial cells that line the small intestine, to break down the lactose so it can be absorbed into the bloodstream. When insufficient amounts of lactase are produced, lactose, passes through the intestines unchanged. Undigested lactose creates an osmotic imbalance which results in less water being reabsorbed by the intestinal lining. It also encourages rapid growth of intestinal bacteria that produce large amounts of gas. Those two factors cause the abdominal bloating, gaseousness, cramping, diarrhea and other symptoms of lactose intolerance, which begin about 30 minutes to 2 hours after eating or drinking foods containing lactose. The severity of symptoms varies depending on the amount of lactose each individual can tolerate. While not all persons deficient in lactase have symptoms, those who do are considered to be lactose intolerant. Web site: http://www.delphion.com/details?pn=US06599882__

Patent Applications on Lactose Intolerance As of December 2000, U.S. patent applications are open to public viewing.6 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to lactose intolerance: •

Composition and method for lactose hydrolysis Inventor(s): Eisenhardt, Peter F.; (Philadelphia, PA), Smith, Leonard P.; (Beesley's Point, NJ) Correspondence: Audley A. Ciamporcero JR.; Johnson & Johnson; One Johnson & Johnson Plaza; New Brunswick; NJ; 08933-7003; US Patent Application Number: 20020172669 Date filed: May 6, 2002 Abstract: The present invention relates to a composition for the enzymatic hydrolysis of lactose containing two lactase enzymes having distinct pH optima. The composition is suitable for treating or controlling the symptoms of lactose intolerance in humans. Excerpt(s): The present invention relates to a composition and method for the enzymatic hydrolysis of lactose and, more particularly, to treating and controlling the symptoms of lactose intolerance. The human digestive system uses a series of enzymes to break down complex foods into simple molecules that can be absorbed by the body. Milk products contain lactose, which, when hydrolyzed, yield glucose and galactose. This hydrolysis is enzymatically catalyzed by lactase or.beta.-D-galactosidase. Decreased or non-existent intestinal lactase activity, known as lactose intolerance, is a deficiency that

6

This has been a common practice outside the United States prior to December 2000.

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appears in pediatric, adolescent and adult populations. The inability to hydrolyze lactose into its component sugars results in bloating, cramping, abdominal pain, or flatulence after the ingestion of milk or dairy products. In severe cases, malabsorption resulting from lactose intolerance may result in anorexia and weight loss. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

METHOD FOR INCREASING LACTOSE EXHIBITING LACTOSE INTOLERANCE

TOLERANCE

IN

MAMMALS

Inventor(s): RITTER, ANDREW J.; (LOS ANGELES, CA) Correspondence: Andrew J. Ritter; 11778 Stonehenge Lane; Los Angeles; CA; 90077; US Patent Application Number: 20020034496 Date filed: July 1, 1999 Abstract: The method for increasing lactose tolerance in subjects exhibiting lactose intolerance symptoms implements a protocol where the subjects ingest a gradually increasing amount of lactose containing product over a six week period. At various points during the six week period the subject ingests the lactose containing product once a day and then twice a day. The lactose containing product can be in liquid form, such as for example, milk, and is preferably in a powder form which is taken either by ingesting capsules having the lactose powder or in a granular form mixed with water or other non-lactose containing liquid. At the end of the six week period, the subject's tolerance for lactose containing products is substantially increased, with the potential of eliminating the subject's lactose intolerant behavior indefinitely. Excerpt(s): This application claims priority from U.S. Provisional Patent Application Ser. No. 60/091,971 filed on Jul. 7, 1998. The present invention relates to a method for increasing lactose tolerance in individuals or mammals who exhibit lactose intolerant symptoms. Lactose Intolerance, or otherwise referred to as lactose maldigestion, is the inability to digest a significant amount of lactose, derived from a deficiency of the lactase enzyme in the small intestines. Lactose is the natural sugar in milk and milk products of all mammals. Lactase is the enzyme which splits the milk sugar lactose into its components (i.e., glucose and galactose), and also breaks down the milk sugar into smaller forms that can be processed into the bloodstream. The lactase enzyme is necessary for mammals to digest lactose. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Reverse isotope dilution assay and lactose intolerance assay Inventor(s): Wagner, David A.; (Nashua, NH) Correspondence: Jenkens & Gilchrist, A Professional Corporation; 1100 Louisiana; Suite 1800; Houston; TX; 77002-5214; US Patent Application Number: 20020159950 Date filed: March 7, 2002 Abstract: A "reverse isotope dilution assay" herein, wherein a pathway that produces a given metabolite is assayed by diluting a labelled metabolite produced by a second constitutive pathway. In one aspect, the invention relates to a method for monitoring lactose maldigestion or lactose intolerance in humans. Specifically, the method requires

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administering a reverse tracer of labeled glucose and unlabeled lactose to an individual and assessing labeled carbon dioxide in breath or blood. If the lactose is digested, the labeled CO.sub.2 produced by the labeled glucose is diluted by the metabolism of the lactose. Excerpt(s): This continuation application claims priority to prior foreign application Japan No. 2001-583819, filed on Jan. 18, 2002, which claims priority to prior International patent application No. PCT/US01/15143, filed May 10, 2001, which claims priority to U.S. provisional patent application Serial No. 60/205,342, filed on May 18, 2000 U.S. provisional application No. 60/205,342, filed May 18, 2000, all of which are incorporated herein by reference in their entirety. Not applicable. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with lactose intolerance, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “lactose intolerance” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on lactose intolerance. You can also use this procedure to view pending patent applications concerning lactose intolerance. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 5. BOOKS ON LACTOSE INTOLERANCE Overview This chapter provides bibliographic book references relating to lactose intolerance. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on lactose intolerance include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “lactose intolerance” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on lactose intolerance: •

On The Celiac Condition: A Handbook for Celiac Patients and Their Families. 2nd ed Source: Omaha, NE: Celiac Sprue Association/United States of America, Inc. 1998. 132 p. Contact: Available from Celiac Sprue Association/USA, Inc. P.O. Box 31700, Omaha, NE 68131-0700. (402) 558-0600. Fax (402) 558-1347. PRICE: $8.00. Summary: Information on celiac sprue is presented to patients with this complex medical disorder. Basic information includes a description of the condition, genetics, diagnosis, treatment, and long-term consequences. Information is discussed regarding all age groups affected by the disease. A gluten-free diet is presented together with recipes, menus, allowable foods, sources for obtaining gluten-free products commercially, and the vitamin/food supplement question is addressed. Lactose intolerance, weight problems, pharmaceuticals, food labeling laws and mental health

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problems are also discussed. Suggestions for airline travel and preparation for hospitalization with celiac sprue are included. A list of resource centers and the most commonly asked questions by people with celiac sprue and their families are included together with a glossary of medical terms relating to the condition. 29 references. •

Medical Advisor Home Edition: The Complete Guide to Alternative and Conventional Treatments Source: Alexandria, VA: Time-Life Books. 1997. 960 p. Contact: Available from Time-Life Books. 400 Keystone Industrial Park, Dunsmore, PA 18512. PRICE: $20.00. ISBN: 0783552505. Summary: This book offers information about 300 health problems, ranging from relatively benign conditions to the most serious diseases. There are symptoms charts which name several related problems and help readers decide which ailment entry to look up. Ailment entries provide a more complete list of symptoms, plus guidelines to discern whether the condition is potentially serious or requires a doctor's attention. Each entry describes the ailment and how it affects the body. Next, the entry outlines the underlying causes of the ailment and the tests and procedures a doctor may use to confirm the diagnosis. The treatment segment presents conventional and alternative recommendations for curing the problem or alleviating the symptoms. Most ailment entries conclude with advice on preventive measures that can be used to maintain health. Alternative treatments discussed include bodywork, acupuncture and acupressure, herbal therapies, homeopathy, lifestyle changes, and nutrition and diet. The book begins with a section on emergency medicine. Also included is a visual diagnostic guide, an atlas to the body, a medicine chest section (describing herbs, homeopathic remedies, and over the counter drugs), a glossary, a subject index, a bibliography, and a list of health associations and organizations. Topics related to digestive diseases include abdominal pain, AIDS, allergies, anal bleeding, anal fissure, anorexia nervosa, bad breath, bowel movement abnormalities, bulimia, celiac disease, cholesterol problems, colitis, colorectal cancer, constipation, Crohn's disease, diarrhea, diverticulitis, flu, food poisoning, gallstones, gas and gas pains, gastritis, gastroenteritis, heartburn, hiatal hernia, hiccups, incontinence, indigestion, irritable bowel syndrome, lactose intolerance, lupus, obesity, pancreatic cancer, pancreatic problems, stomach cancer, stomach ulcers, swallowing difficulty, trichomoniasis, vomiting, and worms. The book is illustrated with line drawings and full-color photographs.

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Eating Hints for Cancer Patients: Before, During and After Treatment Source: Bethesda, MD: National Cancer Institute (NCI), National Institutes of Health (NIH). 1999. 60 p. Contact: Available from National Cancer Institute (NCI). Publications Ordering Service, P.O. Box 24128, Baltimore, MD 21227. Voice (800) 422-6237. TTY (800) 332-8615. Fax (301) 330-7968. PRICE: Single copy free; bulk rates available. NIH Publication Number 99-2079. Summary: This booklet contains a variety of ideas about food needs and eating problems that patients undergoing cancer therapy may encounter. The authors emphasize the need for eating well during cancer treatment and outline the nutrition problems that may arise with different cancer treatments. Strategies for coping with side effects are provided for loss of appetite, sore mouth or throat, changed sense of taste or smell, dry mouth, nausea, vomiting, diarrhea, constipation, weight gain, tooth decay, and lactose intolerance. The next section provides suggestions for increasing protein

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and calorie intake, including the use of healthy snacks. Another section discusses diets for patients with special needs, including the clear liquid diet, full liquid diet, soft diet, fiber restricted diet, low lactose diet, and commercial products to improve nutrition. The booklet includes a glossary of related terms and the contact information for two resource organizations: the Cancer Information Service (800-422-6237) and the American Cancer Society (800-227-2345). The booklet then provides 40 pages of recipes designed to help patients achieve better nutrition during cancer treatment. A recipe index is provided. Colorful drawings illustrate the booklet. 8 tables. •

Instructions for Patients. 5th ed Source: Philadelphia, PA: W.B. Saunders Company. 1994. 598 p. Contact: Available from W.B. Saunders Company. Book Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887-4430. (800) 545-2522. Fax (800) 874-6418. PRICE: $49.95. ISBN: 0721649300 (English); 0721669972 (Spanish). Summary: This paper-bound book presents a number of patient instruction fact sheets. Each fact sheet includes three sections: basic information on signs and symptoms, causes, risk factors, etc.; treatment; and when to contact one's health care provider. Digestive system topics include food allergy, anal fissure, celiac disease, appendicitis, Crohn's disease, constipation, ulcerative colitis, cirrhosis of the liver, cholecystitis or cholangitis, diarrhea, diverticular disease, gallstones, gastritis, hiatal hernia, hemorrhoids, heartburn, irritable bowel syndrome, and lactose intolerance, among others. The fact sheets are designed to be photocopied and distributed to patients as a reinforcement of oral instructions and as a teaching tool. The book is available in English or Spanish.

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Adverse Reactions to Food Source: Chicago, IL: American Dietetic Association. 1991. 74 p. Contact: Available from American Dietetic Association. 216 West Jackson Boulevard, Chicago, IL 60606-6995. (800) 877-1600, ext. 5000. Fax (312) 899-4899. PRICE: $8.45 (ADA members); $9.95 (nonmembers). ISBN: 0880910933. Summary: This publication reviews recent advances regarding immunologically mediated reactions to foods, including the definitions, clinical features, testing and diagnostic procedures, dietary management, and medications used to treat these reactions. Also addressed are lactose intolerance and gluten-induced enteropathy, along with reactions to food additives and sweeteners that are sometimes confused with true sensitivity. A separate section addresses concerns in the pediatric population, including cow's milk sensitivity and attention deficit-hyperactivity disorder. Extensive tables and appendices are included. 9 tables. 137 references.

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Digestive Diseases and Disorders Sourcebook Source: Detroit, MI: Omnigraphics. 2000. 300 p. Contact: Available from Omnigraphics, Inc. 615 Griswold, Detroit, MI 48226. (800) 2341340. Fax (800) 875-1340. PRICE: $48.00 plus shipping and handling. ISBN: 0780803272. Summary: This sourcebook provides basic information for the layperson about common disorders of the upper and lower digestive tract. The sourcebook also includes information about medications and recommendations for maintaining a healthy digestive tract. The book's 40 chapters are arranged in three major parts. The first

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section, Maintaining a Healthy Digestive Tract, offers basic information about the digestive system and digestive diseases, information about tests and treatments, and recommendations for maintaining a healthy digestive system. The second section, Digestive Diseases and Functional Disorders, describes nearly 40 different diseases and disorders affecting the digestive system. These include appendicitis, bleeding in the digestive tract, celiac disease, colostomy, constipation, constipation in children, Crohn's disease, cyclic vomiting syndrome, diarrhea, diverticulosis and diverticulitis, gallstones, gas in the digestive tract, heartburn (gastroesophageal reflux disease), hemorrhoids, hernias, Hirschsprung's disease, ileostomy, indigestion (dyspepsia), intestinal pseudoobstruction, irritable bowel syndrome (IBS), IBS in children, lactose intolerance, Menetrier's disease, rapid gastric emptying, short bowel syndrome, ulcerative colitis, ulcers, Whipple's disease, and Zollinger Ellison syndrome. The final section offers a glossary of terms, a subject index and a directory of digestive diseases organizations (which includes website and email addresses as available). Material in the book was collected from a wide range of government agencies, nonprofit organizations, and periodicals. •

Raising Your Child Without Milk: Reassuring Advice and Recipes for Parents of Lactose-Intolerant and Milk-Allergic Children Source: Rocklin, CA: Prima Publishing. 1996. 374 p. Contact: Available from Prima Publishing. P.O. Box 1260 BK, Rocklin, CA 95677. (916) 632-4400. PRICE: $16.95; quantity discounts available. ISBN: 0761501312. Summary: Written from a parent's perspective, this book offers guidelines for managing a dairy-free diet for a child. Eleven chapters cover differences between lactose intolerance and milk allergy, concerns about calcium, meal planning at home, feeding a dairy-sensitive child at school or day care, kids' meals in restaurants, shopping tips, medications that contain milk products, dealing with pain, and support groups for patients and parents. The book includes 125 dairy-free recipes. The book also includes detailed resource lists, a bibliography, and a subject index. 104 references.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “lactose intolerance” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “lactose intolerance” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “lactose intolerance” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Common Food Intolerances 2: Milk in Human Nutrition and Adult-Type Hypolactasia (Dynamic Nutrition Research, Vol 3) by S. Auricchio, G. Semenza (Editor) (1993); ISBN: 3805557418; http://www.amazon.com/exec/obidos/ASIN/3805557418/icongroupinterna

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Curing Colic and Lactose Intolerance With Homeopathy by Jana Shiloh; ISBN: 0961920300; http://www.amazon.com/exec/obidos/ASIN/0961920300/icongroupinterna

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Dairy-Free Cookbook, Fully Revised 2nd Edition : Over 250 Recipes for People with Lactose Intolerance or Milk Allergy by Jane Zukin (1998); ISBN: 0761514678; http://www.amazon.com/exec/obidos/ASIN/0761514678/icongroupinterna

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How to Tolerate Lactose Intolerance: Recipes & A Guide for Eating Well Without Dairy Products by Phyllis Z. Goldberg; ISBN: 0398068690; http://www.amazon.com/exec/obidos/ASIN/0398068690/icongroupinterna

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Lactose Intolerance by Merri L. Dobler (1991); ISBN: 0880910976; http://www.amazon.com/exec/obidos/ASIN/0880910976/icongroupinterna

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Lactose intolerance : important information for you and your family (SuDoc HE 20.3323:L 11/991) by U.S. Dept of Health and Human Services; ISBN: B000105Y5A; http://www.amazon.com/exec/obidos/ASIN/B000105Y5A/icongroupinterna

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Lactose Intolerance Nutrition Guide by Merri Lou Dobler, Ted G. Meredith (2003); ISBN: 088091307X; http://www.amazon.com/exec/obidos/ASIN/088091307X/icongroupinterna

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Lactose Intolerance: A Resource Including Recipes by American Dietetic Association; ISBN: 0880910143; http://www.amazon.com/exec/obidos/ASIN/0880910143/icongroupinterna

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Living Well With Lactose Intolerance by Jaime Aranda-Michel, et al; ISBN: 0380806428; http://www.amazon.com/exec/obidos/ASIN/0380806428/icongroupinterna

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Milk Is Not for Every Body: Living With Lactose Intolerance by Steve Carper, Robert Kornfield (1996); ISBN: 0452277116; http://www.amazon.com/exec/obidos/ASIN/0452277116/icongroupinterna

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No Milk Today: How to Live With Lactose Intolerance by Steve Carper; ISBN: 0671603019; http://www.amazon.com/exec/obidos/ASIN/0671603019/icongroupinterna

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The Milk Sugar Dilemma: Living with Lactose Intolerance by Sherlyn Martens, et al (1987); ISBN: 0936741015; http://www.amazon.com/exec/obidos/ASIN/0936741015/icongroupinterna

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The Official Patient's Sourcebook on Lactose Intolerance: A Revised and Updated Directory for the Internet Age by Icon Health Publications (2002); ISBN: 0597833974; http://www.amazon.com/exec/obidos/ASIN/0597833974/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “lactose intolerance” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:7 7 In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed

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A study on the prevalence and implications of hypolactasia in Surinam's Bushnegrochildren Author: Zaal, Jan.; Year: 1983; [Amsterdam: s.n., 1977?]

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Lactose intolerance: a resource including recipes. Author: Beaudette, Therese.; Year: 1992; Chicago: American Dietetic Association, c1985; ISBN: 0880910127 http://www.amazon.com/exec/obidos/ASIN/0880910127/icongroupinterna

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Lactose intolerance: January 1977 through December 1979: 187 citations Author: National Library of Medicine (U.S.); Year: 1979; [Bethesda, Md.]: Dept. of Health, Education, and Welfare, Public Health Service, National Institutes of Health, [1979]

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Milk intolerances and rejection Author: Delmont, J.; Year: 1985; Basel; New York: Karger, 1983; ISBN: 3805535465 http://www.amazon.com/exec/obidos/ASIN/3805535465/icongroupinterna

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Milk is not for every body: living with lactose intolerance Author: Carper, Steve.; Year: 1973; New York, NY: Facts on File, c1995; ISBN: 0816031274 http://www.amazon.com/exec/obidos/ASIN/0816031274/icongroupinterna

Chapters on Lactose Intolerance In order to find chapters that specifically relate to lactose intolerance, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and lactose intolerance using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “lactose intolerance” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on lactose intolerance: •

Persistent Diarrheal Disease Source: Kleinmann, R.E., ed. Pediatric Nutrition Handbook. 4th ed. Elk Grove Village, IL: American Academy of Pediatrics. 1998. p. 337-350. Contact: Available from American Academy of Pediatrics. P.O. Box 927, 141 Northwest Point Boulevard, Elk Grove Village, IL 60009-0927. (800) 433-9016. PRICE: $47.95 (members) plus $6.25 shipping and handling; $52.95 for nonmembers; plus $8.95 shipping and handling. ISBN: 1581100051. Summary: Assessment of nutritional status and providing dietary advice and nutritional support are important and increasingly prominent components of the practice of those who provide health care for infants, children, and adolescents. This chapter on persistent diarrheal disease is from a handbook that serves as a ready desk reference on the nutritional requirements and impact of nutritional status on the health of infants, children, and adolescents. Persistent (or chronic) diarrhea is defined by the World Health Organization as any episode of diarrhea that lasts longer than 2 weeks. Persistent diarrhea can be the end result of disorders of intestinal motility, maldigestion,

in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

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malabsorption, or intestinal inflammation. Topics include the evaluation of the infant and child with persistent diarrhea, including history, physical examination, macroscopic and microscopic examination of the stool, examination for fecal carbohydrate, bacterial cultures, sweat chloride, fecal fat, immunoelectrophoresis, tolerance tests, roentgenograms, and invasive procedures (including endoscopy and intestinal biopsy); disorders of motility, including chronic nonspecific diarrhea (toddler's diarrhea); disorders of digestion, including exocrine pancreatic insufficiency (EPI, including cystic fibrosis) and lactose intolerance; disorders of absorption, including celiac disease (gluten-sensitive enteropathy), postgastroenteritis syndrome with persistent diarrhea and malabsorption, short bowel syndrome, and inflammatory bowel disease (IBD, which includes Crohn's disease and ulcerative colitis). 14 references. •

Celiac Disease Source: in King, J.E., ed. Mayo Clinic on Digestive Health. Rochester, MN: Mayo Clinic. 2000. p. 115-124. Contact: Available from Mayo Clinic Health Information. 5505 36th Street, SE, Grand Rapids, MI 49512. (800) 291-1128. Website: www.mayoclinic.com. PRICE: $14.95 plus shipping and handling. ISBN: 1893005046. Summary: Celiac disease damages the small intestine and interferes with its ability to absorb certain nutrients from food. People with celiac disease cannot tolerate gluten, a protein found in wheat, barley, rye, and, possibly, oats. This chapter on celiac disease is from a comprehensive guidebook from the Mayo Clinic that focuses on a variety of digestive symptoms, including heartburn, abdominal pain, constipation, and diarrhea, and the common conditions that are often responsible for these symptoms. Written in nontechnical language, the book includes practical information on how the digestive system works, factors that can interfere with its normal functioning, and how to prevent digestive problems. This chapter first reviews the key signs and symptoms of celiac disease, including diarrhea, abdominal gas and bloating, fatigue, weight loss, and stunted growth (in children with celiac disease). The authors review the inheritance of the condition, the various symptoms that may present with celiac disease, and the main treatment, a diet that is completely without gluten (gluten free). The authors encourage readers to learn about food labeling and caution that food processing may need to be considered when determining if a particular food is gluten free. Other sections offer strategies for eating out at restaurants while following a gluten free diet, and for adapting favorite recipes to be gluten free. Sidebars review the differences between celiac disease and similar conditions, the interrelationship between celiac disease and lactose intolerance (difficulty in digesting the sugars present in dairy products), and hidden sources of gluten. 1 figure.

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Carbohydrate-Modified Diets Source: in Cataldo, C.B., DeBruyne, L.K., and Whitney, E.N. Nutrition and Diet Therapy: Principles and Practice. 4th ed. St. Paul, MN: West Publishing Company. 1995. p. 565594. Contact: Available from West Publishing. 620 Opperman Drive, P.O. Box 64779, St. Paul, MN 55164. (800) 340-9378 or (612) 687-7000. PRICE: $58.25. ISBN: 0314044485. Summary: Diet planners use two types of carbohydrate-modified diets: one type prescribes the amount of carbohydrate whereas the other eliminates a specific type of carbohydrate. This chapter, from a text on nutrition and diet therapy, first describes diabetes mellitus, a disorder that benefits from a carbohydrate-controlled diet. Next, the

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chapter covers hypoglycemia and the dumping syndrome, disorders that benefit from diets that control both the amount and type of carbohydrate. Finally, the authors examine lactose intolerance, a disorder in which one type of carbohydrate, specifically lactose, must be restricted. The section on diabetes covers the treatment of insulindependent diabetes (IDDM), notably the use of insulin, diet and activity, coordinating therapy, and special concerns for children and teens with IDDM; the treatment of noninsulin-dependent diabetes (NIDDM), including the roles of dietary and drug therapies; and diabetes in pregnancy and later life. The chapter concludes with a case study depicting a child with IDDM. •

Milk and Yogurt Source: in Warshaw, H.S. and Webb, R. Diabetes Food and Nutrition Bible: A Complete Guide to Planning, Shopping, Cooking, and Eating. Alexandria, VA: American Diabetes Association. 2001. p. 165-179. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $18.95 plus shipping and handling. ISBN: 158040037. Summary: Milk and milk products are nutritionally quite different from the other food groups. A serving from this group provides both carbohydrate and protein. This chapter on milk and yogurt is from a book that offers a complete food and nutrition resource for people with diabetes. The book brings readers up to date on meal planning, carbohydrate counting, vitamins, minerals, and the best ways to prepare healthy delicious meals. In this chapter the authors discuss the benefits of including milk and yogurt in one's diet, the role of calcium, recommended amounts of calcium, other nutrients in milk and yogurt, other sources of calcium, and coping with lactose intolerance or sensitivity. Recipes are then provided: shrimp and corn bisque, fruit shakes, yogurt cheese, and soy milk smoothies. The chapter concludes with a chart of common milk and milk products and their nutrition values, and a special focus section on blood pressure.

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Ulcerative Colitis Source: in Stein, S.H. and Rood, R.P. Inflammatory Bowel Disease: A Guide for Patients and Their Families. 2nd ed. Philadelphia, PA: Lippincott-Raven Publishers. 1999. p. 3138. Contact: Available from Crohn's and Colitis Foundation of America. 386 Park Avenue South, 17th Floor, New York, NY 10016-8804. (800) 932-2423. Fax (212) 779-4098. E-mail: [email protected]. Website: www.ccfa.org. PRICE: $17.00 for members; $22.00 for nonmembers; plus shipping and handling. ISBN: 0397517718. Summary: This chapter describing ulcerative colitis (UC) is from a text written specifically for people with inflammatory bowel disease (IBD), which is the collective term for ulcerative colitis and Crohn's disease. Ulcerative colitis is an inflammatory disease of the large intestine (the colon), that is characterized by inflammation and ulceration of its inner lining. By contrast, Crohn's disease can affect any area of the gastrointestinal tract, including the small intestine, and there can be areas of normal intestine as well. The author describes the symptoms, diagnosis, and complications of UC as well as its medical and surgical treatment and prognosis. Medical treatment can include three major classes of medications: aminosalicylates, corticosteroids, and immunomodulatory medicines (including azathioprine). In addition, avoiding caffeine

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and lactose (milk sugar) in patients with lactose intolerance can reduce diarrhea in some cases. In addition, bulk forming agents can help decrease the volume of debilitating diarrhea, and antimotility agents can be used to control the diarrhea associated with UC. Surgery is recommended for those patients whose disease is not controllable medically or those who have complications. These can include toxic megacolon and colon cancer, and extraintestinal complications such as anemia, arthritis, skin diseases, certain liver diseases, eye inflammation, and kidney diseases (usually due to dehydration). The course of the disease depends on many factors, including severity, extent, and associated complications. Even though persons with UC may need to take regular medication and may occasionally need to be hospitalized, most continue to lead normal, useful, and productive lives. •

Ineffective Therapies Source: in Manu, P. Pharmacotherapy of Common Functional Syndromes: EvidenceBased Guidelines for Primary Care Practice. Binghamton, NY: Haworth Medical Press. 2000. p. 153-167. Contact: Available from Haworth Medical Press, an imprint of Haworth Press, Inc. 10 Alice Street, Binghamton, New York 13904-1580. (800) HAWORTH or (800) 429-6784. Outside United States and Canada (607) 722-5857. Fax (800) 895-0582. E-mail: [email protected]. Website: www.haworthpressinc.com. PRICE: $69.95 plus shipping and handling. ISBN: 0789005883. Summary: This chapter is from a book that evaluates drug therapies for each of the four major functional disorders: chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome (IBS), and premenstrual syndrome. In this chapter, the fourth of six short chapters that focus on IBS, the author introduces and reviews the ineffective therapies presently in use for the condition. The author focuses on dietary fiber, lactase, and ondansetron. The author's evidence based analysis of a number of studies demonstrates that research performed in the past two decades has established with a high degree of certainty that the administration of dietary fiber is not useful for treating IBS. Lactose (milk sugar) maldigestion can be identified in close to one third of patients diagnosed with IBS, and the symptoms of lactose intolerance or maldigestion are so close to those for IBS as to prevent the clinical identification of this subgroup. Treatment with lactase provided no statistical improvement over placebo. The author reports on a study of ondansetron, in which the drug treatment did not decrease significantly the severity of abdominal pain or the total number of symptoms experienced during the trial. Stool consistency increased after ondansetron therapy. In another study, ondansetron was similar to placebo with regard to its effect on abdominal pain, abdominal distention, backache, urinary symptoms, and depression and anxiety. The only symptoms improved by ondansetron in this population with IBS were postprandial (after a meal) discomfort, belching, and heartburn.

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Everything You Ever Wanted to Ask Your Dietitian About IBS Source: in Magee, E. Tell Me What to Eat If I Have Irritable Bowel Syndrome. Franklin Lakes, NJ: Career Press, Inc. 2000. p. 30-46. Contact: Available from Career Press, Inc. 3 Tice Road, P.O. Box 687, Franklin Lakes, NJ 07417. (800) 227-3371. Website: www.careerpress.com or www.newpagebooks.com. PRICE: $10.99 plus shipping and handling. Summary: This chapter is from a book that offers eating and nutrition guidelines for people who have been diagnosed with irritable bowel syndrome (IBS). People with IBS

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have bowels that tend to overreact in certain situations. Whatever affects the bowels of the population at large, such as diet, hormones, or stress, affects those of people with IS even more, resulting in the symptoms of the disorder. This chapter notes that a big part of treating and managing IBS involves what the patient eats, how and how much they eat, and where they eat. Certain foods and nutrients can help the condition, and others can make symptoms worse. The author emphasizes that IBS is a very individual disorder and that it may take some time for each patient to determine his or her own food triggers. And even for those patients whose IS is particularly affected by stress, limiting personal food triggers during stressful times will contribute to minimizing the resulting symptoms. For readers who are not sure what foods trigger their symptoms, the author recommends the use of an F's (food, feelings, symptoms) journal to help find the links between foods, eating patterns, and symptoms. In addition, the simple act of eating normally causes the muscles in the colon to contract. In people with IBS, the resulting need to defecate may be urgent and occur soon after eating, with accompanying cramps and diarrhea. The author recommends eating smaller meals more often to reduce this post-meal challenge. The author then considers specific food items, including potential problems such as fructose (the natural sugar found in fruits and berries), soft drinks, sorbitol, olestra (a calorie free fat substitute), and chocolate; and vegetables and fruits that tend to be well tolerated by the bowels. The chapter concludes with a lengthy discussion of lactose intolerance and the role it may play in people with IBS. 2 tables. •

Abdominal Pain Source: in Carlson, K.J.; Eisenstat, S.A.; Ziporyn, T. Harvard Guide to Women's Health. Cambridge, MA: Harvard University Press. 1996. p. 1-6. Contact: Available from Harvard University Press. Customer Service Department, 79 Garden Street, Cambridge, MA 02138. (800) 448-2242. Fax (800) 962-4983. PRICE: $24.95 (paperback). ISBN: 0674367693 (paperback). Summary: This chapter on abdominal pain is from a consumer handbook on women's health. The authors discuss the classification and evaluation of abdominal pain and describe causes of pain in different areas. Pain in the lower abdomen may stem from appendicitis, aortic aneurysm, ectopic pregnancy, kidney disorders, bowel disorders, or lactose intolerance. Right upper quadrant pain can be caused by irritable bowel syndrome, liver disease, gallstones and other gallbladder disorders, pancreatic disorders, pneumonia and pleurisy, rib cage pain, or shingles. Pain in the left upper quadrant and midline may be from gastritis, peptic ulcer disease, stomach cancer, or enlarged or ruptured spleen. The chapter concludes with a reference to related chapters in the book. 3 figures.

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Dietary Recommendations for Active and Inactive Ulcerative Colitis Source: in Bayless, T.M. and Hanauer, S.B. Advanced Therapy of Inflammatory Bowel Disease. Hamilton, Ontario: B.C. Decker Inc. 2001. p. 161-164. Contact: Available from B.C. Decker Inc. 20 Hughson Street South, P.O. Box 620, L.C.D. 1 Hamilton, Ontario L8N 3K7. (905) 522-7017 or (800) 568-7281. Fax (905) 522-7839. Email: [email protected]. Website: www.bcdecker.com. PRICE: $129.00 plus shipping and handling. ISBN: 1550091220. Summary: This chapter on dietary recommendations for active and inactive ulcerative colitis (UC) is from the second edition of a book devoted to the details of medical, surgical, and supportive management of patients with Crohn's disease (CD) and UC,

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together known as inflammatory bowel disease (IBD). This chapter discusses the role of diet and nutritional support in ulcerative colitis (UC) in which the catabolic effect (breakdown or loss of body tissue) of inflammation, impaired nutrient absorption, and gastrointestinal (GI) dysfunction can rapidly lead to malnutrition. Inactive UC is a chronic disorder and may be associated with malnutrition, specific elemental deficiencies, and specific food intolerances. Patients may not eat enough to meet their nutritional requirements because of anorexia, drug side effects (eg, nausea, headache, and anorexia), food-induced diarrhea, or pain. In lactose intolerant people, production of hydrogen produces bloating, nausea, and flatulence and unabsorbed short-chain fatty acids produce diarrhea. Lactose intolerance may be primary (racial or congenital) or secondary (eg, due to bacterial overgrowth or intestinal mucosal disease or injury). The incidence of UC is not increased in lactose intolerant people, and the incidence of lactose intolerance is not increased in patients with UC. In UC in remission, lactose restriction is important to control symptoms only in those patients documented to have lactose intolerance, presumably on a genetic basis. Active UC involves pathologic and physiologic changes both within the colonic mucosa and systemically. The colonic mucosa is inflamed and associated with loss of fluid, electrolytes, proteins and immunoglobulins, albumin (protein), and hemoglobin (red blood cells). Systemic manifestations of fever and anorexia are associated with reduced oral intake of nutrients. However, the body is in a catabolic state, with increased nutritional requirements and increased energy needs as a result of fever, associated infections, and steroid therapy. In these situations, nutritional support is essential. In such cases, parental or enteral nutrition not only may be of value but may be essential in patient management. 2 tables. 10 references. •

Gut Feelings Source: in King, J.E., ed. Mayo Clinic on Digestive Health. Rochester, MN: Mayo Clinic. 2000. p. 27-46. Contact: Available from Mayo Clinic Health Information. 5505 36th Street, SE, Grand Rapids, MI 49512. (800) 291-1128. Website: www.mayoclinic.com. PRICE: $14.95 plus shipping and handling. ISBN: 1893005046. Summary: This chapter on digestive tract symptoms ('gut feelings') is from a comprehensive guidebook from the Mayo Clinic that focuses on a variety of digestive symptoms, including heartburn, abdominal pain, constipation, and diarrhea, and the common conditions that are often responsible for these symptoms. Written in nontechnical language, the book includes practical information on how the digestive system works, factors that can interfere with its normal functioning, and how to prevent digestive problems. This chapter reviews the most common digestive complaints, including difficulty swallowing (dysphagia), chest pain and heartburn, belching (burping), bloating and intestinal gas (flatulence or farting), indigestion, nausea and vomiting, abdominal pain, diarrhea or constipation, bleeding, and weight loss. For each of these symptoms, the authors consider the possible causes, and treatment options, including lifestyle or habit changes that may help the problem. One sidebar reviews lactose intolerance (problems digesting the sugars in dairy products); another reviews the problem and treatment of hemorrhoids. Readers are referred to other chapters in the book for additional information about specific problems.

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Food Intolerance and Food Allergies: 'Was It Something I Ate?' Source: in Janowitz, H.D. Indigestion: Living Better with Upper Intestinal Problems from Heartburn to Ulcers and Gallstones. New York, NY: Oxford University Press. 1992. p. 163-173. Contact: Available from Oxford University Press. Order Department, 2001 Evans Road, Cary, NC 27513. (800) 451-7556. Fax (919) 677-1303. PRICE: $11.95 plus shipping and handling. ISBN: 019508554X. Summary: This chapter on food intolerance and food allergies is from a book that offers advice on how to take care of and avoid the whole complex of disturbances categorized as indigestion. The author notes that no one doubts that food allergies exist, but because controversy and possible quackery surround the whole subject, doctors approach it with great caution. The major problem is proving that symptoms blamed on food allergies are really caused by the food under consideration. Common symptoms include gastrointestinal symptoms (nausea, vomiting, diarrhea, abdominal pain), distant symptoms (hives, swelling of the lips and throat, eczema), asthma and swelling of the nasal passages, and migraine. The diagnostic tests used for food allergies are hard to interpret and are unreliable. The author outlines the terminology used in this area, including food intolerance, food idiosyncrasy, and food allergy, and also discusses wheat intolerance (gluten, the wheat protein), the role of a food diary in diagnosis, the use of elimination diets, elemental diets, and core diets, and the role of medications in treating food allergies. The author stresses that the real cure for food allergies or food intolerances is the elimination of the offending substance. Lactase can help in lactose intolerance, but in general, drugs are not helpful except to provide some symptomatic relief.

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Sensitive About Food Source: in Duyff, R.L. American Dietetic Association's Complete Food and Nutrition Guide. Minneapolis, MN: Chronimed Publishing. 1996. p. 189-204. Contact: Available from Chronimed Publishing. P.O. Box 59032, Minneapolis, MN 55459. (800) 848-2793 or (612) 541-0239. Fax (800) 395-3344 or (612) 541-0210. PRICE: $29.95; bulk orders available. ISBN: 1565610989. Summary: This chapter on food sensitivity is from a food and nutrition guide that focuses on a healthful diet for all stages of life. The author considers various reasons why people may be sensitive to food: food intolerances, food allergies, adverse reactions (including to contaminated food), and psychosocial reasons. Some people experience food intolerances in which, for metabolic reasons, their bodies can't digest part of certain foods or a food component. Food allergies can trigger the body's immune system and create unpleasant and sometimes serious symptoms. Adverse reactions also occur for other reasons: infectious organisms such as bacteria, parasites, or viruses that cause foodborne illness; or contaminants such as chemicals in water where seafood is harvested. Feelings of discomfort after eating can also be psychological because food is connected to so many emotions. Even though there is no physical reason, just thinking about a certain food that may be associated with an unpleasant experience can make some people feel ill. Specific topics include lactose intolerance, gluten intolerance, sulfite sensitivity, food coloring and additives, intense sweeteners (aspartame, saccharin, acesulfame K), the symptoms of food allergies, and suggestions for preventing and managing allergic reactions to food.

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Gastrointestinal Disease in the Aged Source: in Reichel, W., et al., eds. Care of the Elderly: Clinical Aspects of Aging. 4th ed. Baltimore, MD: Williams and Wilkins. 1995. p. 198-205. Contact: Available from Williams and Wilkins. 351 West Camden Street, Baltimore, MD 21201-2436. (800) 638-0672 or (410) 528-4223. Fax (800) 447-8438 or (410) 528-8550. PRICE: $69.00 (as of 1996). ISBN: 0683072099. Summary: This chapter on gastrointestinal (GI) disease in the aged is from a text on the clinical aspects of aging. This chapter covers problems associated with the esophagus, the stomach, the small bowel and pancreas, and the colon and rectum; liver disease; biliary disease; and pancreatic disease. Specific conditions discussed include appendicitis, heartburn, dysphagia, drug-induced gastritis, gastroparesis, lactose intolerance, inflammatory bowel disease, diverticulosis, colon cancer, constipation, fecal incontinence, irritable bowel syndrome, jaundice, hepatitis, gallstones, pancreatitis, and pancreatic cancer. 1 table. 22 references.

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Malabsorption and Maldigestion: Internal Starvation Source: in Janowitz, H.D. Indigestion: Living Better with Upper Intestinal Problems from Heartburn to Ulcers and Gallstones. New York, NY: Oxford University Press. 1992. p. 153-162. Contact: Available from Oxford University Press. Order Department, 2001 Evans Road, Cary, NC 27513. (800) 451-7556. Fax (919) 677-1303. PRICE: $11.95 plus shipping and handling. ISBN: 019508554X. Summary: This chapter on malabsorption and maldigestion is from a book that offers advice on how to take care of and avoid the whole complex of disturbances categorized as indigestion. To obtain nutritional benefits from eating, two complex processes must take place. First, the intestinal tract must digest (break down) the complex foods that are eaten; second, the intestinal lining cells must absorb these smaller parts across the intestinal wall so that the bloodstream can convey them to the tissues. The author first defines malnutrition, but notes that malnutrition is not covered in this chapter. Individuals with maldigestion and malabsorption usually have good appetites and ready access to food; their bodies are starving in the presence of plenty, not because they are not eating enough. The key symptoms of most malabsorptive problems are loss of weight (for adults) and failure to gain and grow (in children). The author reviews the symptoms of malabsorption, diagnostic tests used to confirm the condition, the common causes of malabsorption (including lactose intolerance and gluten enteropathy), the differences between maldigestion (failure to break down the diet into its constituent parts) and malabsorption (failure to absorb the diet), the different types of maldigestion (of carbohydrates and starches, of fats, and of protein), and treatment options for maldigestion.

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Nutrition Basics Source: in Korn, D. Kids with Celiac Disease: A Family Guide to Raising Happy, Healthy, Gluten-Free Children. Bethesda, MD: Woodbine House. 2001. p. 159-182. Contact: Available from Woodbine House. 6510 Bells Mill Road, Bethesda, MD 20817. (800) 843-7323 or (301) 897-3570. Fax (301) 897-5838. E-mail: [email protected]. Website: www.woodbinehouse.com. PRICE: $17.95 plus shipping and handling. ISBN: 1890627216.

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Summary: This chapter on nutrition is from a practical survival guide for families of children and teenagers with celiac disease, a lifelong digestive disorder that affects nearly two million Americans. Celiac disease results from an intolerance of gluten, a protein found in wheat, rye, barley, and oats, and any food made with these grains. Removing gluten from the diet is the only known treatment for this illness. Left untreated, the disease can lead to serious conditions such as damage to the central nervous system, osteoporosis, and cancer. In this chapter, the author helps parents and children achieve a healthy, balanced diet when so many foods are forbidden. In addition, before the child's celiac disease is controlled, he or she can have nutritional deficiencies that need to be addressed and corrected. And, as with any children, parents may encounter special nutritional issues, such as a child who wants to become a vegetarian, or one who goes on food jags, or one who needs additional calories. The author discusses the food guide pyramid, the five food groups used in the pyramid (with specific suggestions offered in each group), nutrient imbalances and deficiencies related to celiac disease (carbohydrates, protein, fat, fat soluble vitamins, calcium, magnesium, zinc, iron, folate or folic acid, vitamin B12, and electrolytes), disaccharide intolerance (including lactose intolerance), making snacks healthy and fun, managing food jags, boosting calories and nutrients in the child's diet, and the importance of working with a dietitian with any additional questions parents may have. The chapter includes black and white photographs of children, and sidebars sharing quotations from parents. •

Problems in the Lower Digestive Tract Source: in Balch, J.F. and Walker, M. Heartburn and What to Do About It. Garden City Park, NY: Avery Publishing Group. 1998. p. 29-45. Contact: Available from Avery Publishing Group. 120 Old Broadway, Garden City Park, NY 11040. (800) 548-5757 or (516) 741-2155. Fax (516) 742-1892. E-mail: [email protected]. PRICE: $10.95 plus shipping and handling. ISBN 0895297922. Summary: This chapter on problems in the lower digestive tract is from a book in which the authors tell readers how to banish heartburn and other digestive symptoms once and for all, using natural therapies that are gentle on one's system. The authors emphasize that a lack of balance in the digestive tract, caused by improper diet and the stresses of modern life, is at the root of most people's intestinal upsets, and they explain both the problem and the solution in clear, nontechnical language. In this chapter, the authors note that diarrhea and constipation are two of the most common symptoms of trouble in the lower gastrointestinal (GI) tract. The authors first offer a quick review of the organs and functions of the lower GI tract, then look at the disorders that affect this part of the body. The lower GI tract includes most of the small intestine (or small bowel), the large intestine (or large bowel), and the anus. Disorders discussed include malabsorption and intolerance disorders, including celiac disease and lactose intolerance; diarrhea and infectious diseases; obstructive diseases and disorders, including polyps, intestinal obstruction, and cancer; other bowel diseases and disorders, including constipation, inflammatory bowel diseases (IBD, including Crohn's disease and ulcerative colitis), diverticular diseases, irritable bowel syndrome (IBS), appendicitis, and ischemic blood disease (tissue damage due to insufficient blood supply to the intestine); rectal and anal disorders, including fistulas (abnormal openings between the rectum and the skin), fissures (cracks in the lining of the anus), hemorrhoids, and proctitis (irritation of the anal area); and abdominal cavity disorders, including peritonitis and hernia. 12 references.

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Diagnosis: Tests, Tests, and More Tests Source: in Korn, D. Kids with Celiac Disease: A Family Guide to Raising Happy, Healthy, Gluten-Free Children. Bethesda, MD: Woodbine House. 2001. p. 141-158. Contact: Available from Woodbine House. 6510 Bells Mill Road, Bethesda, MD 20817. (800) 843-7323 or (301) 897-3570. Fax (301) 897-5838. E-mail: [email protected]. Website: www.woodbinehouse.com. PRICE: $17.95 plus shipping and handling. ISBN: 1890627216. Summary: This chapter on the diagnosis of celiac disease is from a practical survival guide for families of children and teenagers with celiac disease, a lifelong digestive disorder that affects nearly two million Americans. Celiac disease results from an intolerance of gluten, a protein found in wheat, rye, barley, and oats, and any food made with these grains. Removing gluten from the diet is the only known treatment for this illness. Left untreated, the disease can lead to serious conditions such as damage to the central nervous system, osteoporosis, and cancer. In this chapter, the author explains the different diagnostic tests that may be utilized in confirming a diagnosis of celiac disease. The author notes that while the procedures involved in diagnosing celiac disease are relatively simple, getting a physician to perform those procedures and arrive at a diagnosis can be difficult. If the child has symptoms, or even if there are no symptoms but celiac disease runs in the family, it is absolutely imperative that parents insist on having the child tested. The author describes how to find a competent specialist (gastroenterologist), testing methods (serum antibody test, small bowel endoscopy and biopsy, and genetic testing), other tests that may indicate celiac disease (fatty stool tests and tests for malabsorption), preparing the child for testing, the use of a gluten free diet as a way to diagnose the disease (not recommended), ongoing testing, testing siblings, the consequences of misdiagnosis (risk of lactose intolerance, adverse effects on bones, and infertility and complications during pregnancy), and research efforts in celiac disease. The author concludes by emphasis that a diagnosis of celiac disease can be a relief. Although the child will never outgrow celiac disease, no medications or surgical procedures are required to ensure a lifetime of happiness and good health. The chapter includes black and white photographs of children, and sidebars sharing quotations from parents.

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Gastrointestinal System Source: in Kelly, R.B., ed. Family Health and Medical Guide. Dallas, TX: Word Publishing. 1996. p. 169-200. Contact: Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237. Website: www.aafp.org. PRICE: $30.00 for members; $35.00 for non-members; plus shipping and handling. ISBN: 0849908396. Summary: This chapter on the gastrointestinal system is from a family health and medical guide. The chapter first describes the anatomy and function of the gastrointestinal tract, including the mouth, esophagus, stomach, small intestine, pancreas, gallbladder, liver, and large intestine. The chapter then covers problems of the gastrointestinal system, such as anal abscesses, fissures, and itching; appendicitis; bowel blockage; carcinoid tumors; colon polyps; colorectal cancer; constipation; Crohn's disease; dehydration; diarrhea; diverticulosis and diverticulitis; esophageal cancer and varices; gas; gastroenteritis; heartburn; hemorrhoids; hernias (hiatal and inguinal); ileus; irritable bowel syndrome (IBS); malabsorption (including celiac disease, lactose intolerance, pernicious anemia, postsurgical malabsorption, and Whipple's disease);

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peritonitis; proctitis; stomach cancer; ulcers; ulcerative colitis; and vomiting. For each topic, the authors discuss symptoms, diagnostic tests, treatment options, and prevention. Numerous sidebars cover home remedies for constipation; symptoms of a serious bowel problem; ways to prevent dehydration in adults; the BRAT (bananas, rice, apples, toast) diet; ways to prevent esophageal cancer, gas, and heartburn; hiccups; and home remedies for irritable bowel, as well as when to call the doctor about nausea or vomiting. 10 figures. •

Food Allergies and Adverse Food Reactions: An Anthropological Perspective Source: in Perkin, J.E., ed. Food Allergies and Adverse Reactions. Frederick, MD: Aspen Publishers, 1990. p. 207-232. Contact: Available from Aspen Publishers, Inc. 7201 McKinney Circle, Frederick, MD 21701-9782-9782. (800) 638-8437 or (301) 417-7500. PRICE: $49. Summary: This chapter, from a book on food allergies and adverse food reactions, is based on the review of a scant body of literature from nutritional and medical anthropology, nutritional geography, and epidemiology. In this chapter, the authors discuss anthropological approaches to adverse food reactions and, when applicable, the sociopsychological and biocultural factors that explain these food-related behaviors and physiological responses. In the last section of the chapter, the authors focus on interactions between minority clients and nutritionists or dietitians. The problems arising in transcultural or cross-cultural therapeutic encounters are discussed. The authors also suggest a number of techniques for promoting more effective nutrition education and better adherence to recommended changes in diet and food-related behaviors. Specific syndromes discussed include gluten intolerance (celiac disease) and lactose intolerance. 83 references.

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Helping Digestive Problems Source: in Rob, C.; Reynolds, J. Caregiver's Guide: Helping Elderly Relatives Cope with Health and Safety Problems. Boston: Houghton Mifflin Company. 1991. p. 116-145. Contact: Available from Houghton-Mifflin Company. 2 Park Street, Boston, MA 02108. (800) 255-3362. PRICE: $12.95 (paperback) or $22.95 (cloth), plus shipping and handling. ISBN: 0395500869. Summary: This chapter, from a caregiver's guide to helping elderly people handle health and safety problems, addresses digestive problems. Topics covered include dry mouth, swallowing difficulties, lactose intolerance, constipation, hemorrhoids, diverticular disease, iron-deficiency anemia, pernicious anemia or vitamin B12 deficiency, peptic ulcers, heartburn, and gastrointestinal cancer. Practical advice, case stories, and dietary suggestions combined with sound medical information are provided for each condition discussed.

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Nutrition Overview Source: in Du Bois, D. Enteral Feedings in the Nursing Home. La Grange, TX: M and H Publishing Company, Inc. 1990. p. 13-25. Contact: Available from M and H Publishing Company, Inc. P.O. Box 268, La Grange, TX 78945-0268. (409) 968-9508. PRICE: $10.95 plus $2.50 shipping and handling. ISBN: 1877735205.

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Summary: This chapter, from a nursing guidebook about enteral feedings in the nursing home population, presents an overview of certain aspects of nutrition that are known to affect the quality of nutrition supplied to a tube-fed patient. The author stresses that present knowledge about nutrition has been obtained almost entirely from research in younger subjects; nutrition for those over 70 years of age may require a different approach. Topics include protein; carbohydrates; fructose intolerance; lactose intolerance; fat; water; vitamins and minerals; energy requirements; ideal body weights; the effects of malnutrition on the cardiovascular system, on the lungs and respiration, on the gastrointestinal tract, the pancreas, liver, and kidney; histological effects of malnutrition; the effect of malnutrition on susceptibility to infection and wound healing; and the signs and symptoms of malnutrition. 6 tables. 25 references. •

Coexistent Irritable Bowel Syndrome and Inflammatory Bowel Disease Source: in Bayless, T.M. and Hanauer, S.B. Advanced Therapy of Inflammatory Bowel Disease. Hamilton, Ontario: B.C. Decker Inc. 2001. p. 91-94. Contact: Available from B.C. Decker Inc. 20 Hughson Street South, P.O. Box 620, L.C.D. 1 Hamilton, Ontario L8N 3K7. (905) 522-7017 or (800) 568-7281. Fax (905) 522-7839. Email: [email protected]. Website: www.bcdecker.com. PRICE: $129.00 plus shipping and handling. ISBN: 1550091220. Summary: This second chapter on the coexistence of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) is from the second edition of a book devoted to the details of medical, surgical, and supportive management of patients with Crohn's disease (CD) and ulcerative colitis (UC), together known as IBD. Irritable bowel syndrome (IBS) is a chronic abdominal symptom complex for which no structural underlying abnormality can be demonstrated. It is a common disorder that affects all age groups with an increased frequency in females. Few if any of the clinical features of IBS can confidently distinguish it from IBD. This chapter focuses on the prevalence of IBS, clinically relevant pathophysiology, and the importance of the patient-physician relationship. The author notes that there are several pathophysiologic alterations found in the small bowel and colon of patients with IBS that could be aggravated or brought to the level of clinical awareness by IBD or its treatment. These alterations include pain or diarrhea after ileo-right colon resection (removal); active proctosigmoiditis; ileal pouch procedures; and an exaggeration of the patient's response to secretagogues, including caffeine and problems with lactose intolerance. The author emphasizes the benefits of explaining to the patient with both IBS and IBD the fact that she or he has two different disorders and that each may cause its own symptoms. Explaining the pathophysiology seems to help the patient adjust medications and understand and accept symptoms caused by meals or by stress. 6 references.

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Postgastrectomy Diet Source: in American Dietetic Association. Manual of Clinical Dietetics. Chicago, IL: American Dietetic Association. 1996. p. 411-417.PD. Contact: Available from American Dietetic Association. 216 West Jackson Boulevard, Chicago, IL 60606. (800) 877-1600 or (312) 899-0040. Fax (312) 899-4899. PRICE: $59.95 for members, $70.00 for nonmembers. ISBN: 0880911530. Summary: This section describing a postgastrectomy diet is from a manual that serves as a nutrition care guide for dietetics professionals, physicians, nurses, and other health professionals. The manual integrates current knowledge of nutrition, medical science, and food to set forth recommendations for healthy individuals and those for whom

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medical nutrition therapy (MNT) is indicated. The postgastrectomy diet is designed to provide adequate calories and nutrients to support tissue healing and to prevent weight loss and dumping syndrome after gastric surgery. A postgastrectomy diet is used for persons who undergo a surgical procedure involving bypass or excision of the pylori sphincter, resulting in the body's inability to regularly empty the stomach. The text outlines the purpose, use, modifications, and adequacy of the diet. The section also notes the related physiology, discussing dumping syndrome, lactose intolerance, hypoglycemia, steatorrhea, and vitamin and mineral deficiencies. A brief sample menu is included. 2 tables. 11 references. (AA-M). •

Lactose-Controlled Diet Source: in American Dietetic Association. Manual of Clinical Dietetics. Chicago, IL: American Dietetic Association. 1996. p. 419-424. Contact: Available from American Dietetic Association. 216 West Jackson Boulevard, Chicago, IL 60606. (800) 877-1600 or (312) 899-0040. Fax (312) 899-4899. PRICE: $59.95 for members, $70.00 for nonmembers. ISBN: 0880911530. Summary: This section outlining a lactose-controlled diet is from a manual that serves as a nutrition care guide for dietetics professionals, physicians, nurses, and other health professionals. The manual integrates current knowledge of nutrition, medical science, and food to set forth recommendations for healthy individuals and those for whom medical nutrition therapy (MNT) is indicated. The lactose-controlled diet is designed to prevent or reduce gastrointestinal symptoms of bloating, flatulence, cramping, nausea, and diarrhea associated with consumption of the disaccharide lactose. The diet is a general one that restricts or eliminates lactose-containing foods. Lactose is primarily found in dairy products but may be present as an ingredient or component of various food products. The text outlines the purpose, use, modifications, and adequacy of the diet. The section also notes the related physiology, particularly of the varying levels of lactose intolerance. A brief sample menu is included. The addresses for two manufacturers of special products are provided. 3 tables. 9 references. (AA-M).

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CHAPTER 6. MULTIMEDIA ON LACTOSE INTOLERANCE Overview In this chapter, we show you how to keep current on multimedia sources of information on lactose intolerance. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on lactose intolerance is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “lactose intolerance” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “lactose intolerance” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on lactose intolerance: •

Body Invaders: Digestion Source: Princeton, NJ: Films for the Humanities and Sciences. The Discovery Channel. 2000. (videorecording). Contact: Available from Films for the Humanities and Sciences. PO Box 2053 Princeton, NJ 08543-2053. (800) 257-5126. Fax: (609) 275-3767. Website: www.films.com. PRICE: $89.95. Order number: BVL29621. Summary: In this program, host Kat Carney explores all 24 feet of the human gastrointestinal tract, stopping at each stage of digestion for a close up study of the organs involved. The program also covers foodborne illnesses, gastroesophageal reflux disease, lactose intolerance, ulcers caused by Helicobacter pylori, Crohn's disease, and traveler's diarrhea. The program includes interviews with and narration by experts from Tufts Medical School's Lahey Clinic, the City of Boston Health Department, and the New England Medical Center. The program features operating room footage of

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gallbladder surgery and intestinal imaging via colonoscopy. This program is one of an 11-part series called The Body Invaders that reveals the facts and fallacies of some common illnesses, disorders, and conditions. •

When Milk Doesn't Do a Body Good Source: Madison, WI: University of Wisconsin Hospitals and Clinics, Department of Outreach Education. 1996. (videocassette). Contact: Available from University of Wisconsin Hospital and Clinics. Picture of Health, 702 North Blackhawk Avenue, Suite 215, Madison, WI 53705-3357. (800) 757-4354 or (608) 263-6510. Fax (608) 262-7172. PRICE: $19.95 plus shipping and handling; bulk copies available. Order number 032096A. Summary: Lactose, the sugar component of milk, is made of glucose and galactose. The intestine cannot digest complex sugar, so the body needs the enzyme lactase to break lactose into these simpler sugars. Without adequate lactase levels, symptoms of lactose intolerance can become problematic. This videotape is one in a series of health promotion programs called 'Picture of Health,' produced by the University of Wisconsin. In this program, moderated by Mary Lee and featuring gastroenterologist Mark Lloyd, the common symptoms, diagnosis, and management of lactose intolerance are covered. Dr. Lloyd explains why some people cannot digest milk, defines lactose intolerance, notes who is most affected, and reviews treatment options. Rarely, an infant is born with no lactase; these few children become sick early in life and are usually diagnosed quickly. However, most humans (and other mammals) have no problems with milk in the early years. About 75 percent of the world's population has some problems with lactose; levels vary by ethnic group. The symptoms of lactose intolerance include stomach rumbling and bloating, gas (flatulence), and diarrhea. Dr. Lloyd reviews the differences between lactose intolerance and milk allergy, which is an immunologic reaction. The program then focuses on the diagnosis and management of lactose intolerance. Lactose withdrawal (removing milk and milk products from the diet) or lactose tolerance testing (blood sugar tests and breath hydrogen tests) are used for diagnosis; sometimes biopsy is indicated. The program lists foods high in lactose and offers readers suggestions for dietary modification and the use of lactase supplements. The program concludes by referring viewers to the National Digestive Diseases Information Clearinghouse (NDDIC).

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Barbershop Talk: Benny's Advice on Healthy Eating: A Nutrition Video for the Black Community Source: Southampton, PA: Dairy Council, Inc. 199x. (videocassette with leader's guide, participant cards, and education materials). Contact: Available from Dairy Council, Inc. 1225 Industrial Highway, Southampton, PA 18966-4010. (215) 322-0450. PRICE: $15 for video and all instructional materials. Video alone available for $12. Additional Leader's Guides and participant cards also available separately. Summary: This nutrition videotape on health targets black males. The videotape shows a group of African American men in an everyday setting talking about nutrition and health. Topics include high blood pressure, controlling dietary fats, lactose intolerance, the basic four food groups, soul food, and weight control. The packet includes the videotape, a leader's guide, 25 participant's cards, and Dairy Council education materials. The materials focus on the prevention of common health problems in this population, notably hypertension and diabetes.

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Bibliography: Multimedia on Lactose Intolerance The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in lactose intolerance (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on lactose intolerance: •

Lactase deficiency and lactose tolerance test [slide]: laboratory tests for malabsorption Source: Thomas Trainer, Ronald Picoff, David Duffell; produced at the ASCP Educational Center; Year: 1972; Format: Slide; [Chicago: American Society of Clinical Pathologists, c1972]

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Lactose intolerance [slide] Source: McMaster University, Health Sciences; Year: 1978; Format: Slide; [Hamilton, Ont.]: The University, c1978

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CHAPTER 7. PERIODICALS AND NEWS ON LACTOSE INTOLERANCE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover lactose intolerance.

News Services and Press Releases One of the simplest ways of tracking press releases on lactose intolerance is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “lactose intolerance” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to lactose intolerance. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “lactose intolerance” (or synonyms). The following was recently listed in this archive for lactose intolerance: •

Prometheus Labs to create DNA-based lactose intolerance test Source: Reuters Industry Breifing Date: October 10, 2002

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•

Peak bone mass reduced in people with lactose intolerance Source: Reuters Medical News Date: July 29, 2002

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Two DNA variants associated with lactose intolerance Source: Reuters Medical News Date: January 14, 2002

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Gene variation found for lactose intolerance Source: Reuters Health eLine Date: January 14, 2002

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Low-lactose diet does not benefit IBS patients with lactose intolerance Source: Reuters Medical News Date: March 26, 2001

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Gene therapy effective for lactose intolerance in animals Source: Reuters Medical News Date: October 02, 1998

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Gene therapy for lactose intolerance Source: Reuters Health eLine Date: September 29, 1998

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Lactose Intolerance Is "Overrated" Source: Reuters Medical News Date: July 06, 1995 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “lactose intolerance” (or synonyms) into the search box, and click on “Search News.” As this service

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is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “lactose intolerance” (or synonyms). If you know the name of a company that is relevant to lactose intolerance, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “lactose intolerance” (or synonyms).

Newsletters on Lactose Intolerance Find newsletters on lactose intolerance using the Combined Health Information Database (CHID). You will need to use the “Detailed Search” option. To access CHID, go to the following hyperlink: http://chid.nih.gov/detail/detail.html. Limit your search to “Newsletter” and “lactose intolerance.” Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter.” Type “lactose intolerance” (or synonyms) into the “For these words:” box. The following list was generated using the options described above: •

Aiding Calcium Absorption Source: Newsletter for People with Lactose Intolerance and Milk Allergy. Summer 1990. 2 p. Contact: Available from Newsletter for People with Lactose Intolerance and Milk Allergy. P.O. Box 3129, Ann Arbor, MI 48106-3129. (313) 572-9134. Summary: This article, from a newsletter for people who have lactose intolerance or milk allergy, discusses ways to aid calcium absorption. Topics include the body's need for calcium, getting calcium from foods or from supplements, the role of calcium in preventing disease, the need for calcium supplements for people who cannot eat dairy foods, ways to aid calcium absorption in the body, and finding a balance of foods and supplements to best meet the body's need for calcium. The article concludes with the recommendation for annual calcium level checks.

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New Testing Techniques for Irritable Bowel Syndrome Source: Newsletter for People with Lactose Intolerance and Milk Allergy. p. 3-4. Spring 1993.

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Contact: Available from Newsletter for People with Lactose Intolerance and Milk Allergy. P.O. Box 3129, Ann Arbor, MI 48106-3129.\ (313) 572-9134. Summary: This brief article, from a newsletter for people with lactose intolerance and milk allergy, reports on new testing techniques available for irritable bowel syndrome (IBS). Topics include the various etiologic agents possibly responsible for IBS; the traditional diagnostic methods used to confirm IBS; and the new test, called a bowel scintiscan, that reveals gaps in the emptying process of the large intestine. These gaps indicate areas of the bowel that function abnormally, therefore demonstrating the presence of IBS. The article notes that the test is still experimental and is only available through the Mayo Clinic in Rochester, Minnesota.

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “lactose intolerance” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on lactose intolerance: •

Genetics of Lactose Intolerance Source: Harvard Heart Letter. 9(7): 6. March 2002. Contact: Available from Harvard Medical School Health Publications Group. Harvard Heart Letter, P.O. Box 420300, Palm Coast, FL 32142-0300. (800) 829-9045. E-mail: [email protected]. Website: www.health.harvard.edu. Summary: This brief article from a health newsletter reviews the genetics of lactose intolerance in women. People who are lactose intolerant have a shortage of the enzyme lactase that prevents them from digesting large amounts of lactose, the main sugar in dairy products. The physical effects can be distressing: stomach pain, nausea, cramps, bloating, gas, and diarrhea. The article cautions that avoiding dairy products can result in too little dietary calcium and thus leave women at risk of osteoporosis; in addition, many symptoms attributed to lactose intolerance may really be due to a common intestinal disorder called irritable bowel syndrome (IBS), which can sometimes overlap with lactase deficiency. A study in the journal Nature Genetics (February 2002) reports on the results of research that may eventually lead to the development of a simple blood test to help doctors diagnose lactose intolerance more easily. The authors conclude that more work is needed to turn this genetic discovery into a convenient and reliable diagnostic test. One sidebar offers practical suggestions for women who are lactose intolerant.

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History of Lactose Intolerance Source: Newsletter for People with Lactose Intolerance and Milk Allergy. p. 1-3. June 1995. Contact: Available from Newsletter for People with Lactose Intolerance and Milk Allergy. P.O. Box 3129, Ann Arbor, MI 48106-3129. (313) 572-9134.

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Summary: This newsletter article familiarizes readers with the history of lactose intolerance. Topics include the recent acceptance of lactose intolerance as a legitimate diagnosis; early animal studies on lactase enzyme activity; primary lactose intolerance; differences in lactose tolerance among various ethnic groups; the impact of dairying on the consumption of milk; the adaptation hypothesis versus the cultural historical hypothesis; and questions regarding lactase enzyme production and lactose intolerance. •

Marketers Milk Misconceptions on Lactose Intolerance Source: Tufts University Diet and Nutrition Letter. 12(10): 4-7. December 1994. Summary: This newsletter article reviews recent advertising for products designed to help people who are lactose intolerant use dairy products. The author contends that any reported rise of lactose intolerance probably is not a true epidemic, but the result of an increase in product marketing. Topics include definitions of lactose intolerance; intolerance versus maldigestion; research studies; cultural influences; diagnostic tests, including self-test kits promoted by the manufacturer of lactose-reduced milk and pills that contain the enzyme necessary for digesting milk sugar; transitory lactose intolerance due to illness; dietary suggestions; food labeling; lactose in prescription and over-the-counter medications; and milk allergy.

Academic Periodicals covering Lactose Intolerance Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to lactose intolerance. In addition to these sources, you can search for articles covering lactose intolerance that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 8. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for lactose intolerance. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with lactose intolerance. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.).

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The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to lactose intolerance: Racemethionine •

Systemic - U.S. Brands: M-Caps; Pedameth; Uracid http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202727.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute8: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

8

These publications are typically written by one or more of the various NIH Institutes.

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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.9 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:10 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

9

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 10 See http://www.nlm.nih.gov/databases/databases.html.

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Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway11 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.12 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “lactose intolerance” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 2393 39 197 3 0 2632

HSTAT13 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.14 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.15 Simply search by “lactose intolerance” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

11

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

12

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 13 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 14 15

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists16 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.17 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.18 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

The Genome Project and Lactose Intolerance In the following section, we will discuss databases and references which relate to the Genome Project and lactose intolerance. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).19 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. 16 Adapted 17

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 18 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process. 19 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.

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To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “lactose intolerance” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for lactose intolerance: •

Hypolactasia, Adult Type Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?223100

•

Lactase Deficiency, Congenital Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?223000

•

Lactose Intolerance, Congenital Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?150220 Genes and Disease (NCBI - Map)

The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed: •

Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html

•

Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html

•

Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html

•

Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html

•

Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome,

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Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html •

Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html

•

Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html Entrez

Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: •

3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

•

Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books

•

Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome

•

NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/

•

Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide

•

OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM

•

PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset

•

ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

•

Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein

•

PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed

•

Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure

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Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy

To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “lactose intolerance” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database20 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database21 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “lactose intolerance” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).

20

Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 21 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on lactose intolerance can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internetbased services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to lactose intolerance. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to lactose intolerance. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “lactose intolerance”:

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•

Guides on lactose intolerance Lactose Intolerance http://www.nlm.nih.gov/medlineplus/lactoseintolerance.html

•

Other guides Child Nutrition http://www.nlm.nih.gov/medlineplus/childnutrition.html Diabetes http://www.nlm.nih.gov/medlineplus/diabetes.html Food Allergy http://www.nlm.nih.gov/medlineplus/foodallergy.html Genetic Brain Disorders http://www.nlm.nih.gov/medlineplus/geneticbraindisorders.html Metabolic Disorders http://www.nlm.nih.gov/medlineplus/metabolicdisorders.html Metabolic Syndrome X http://www.nlm.nih.gov/medlineplus/metabolicsyndromex.html Osteoporosis http://www.nlm.nih.gov/medlineplus/osteoporosis.html Phenylketonuria http://www.nlm.nih.gov/medlineplus/phenylketonuria.html Vitamin and Mineral Supplements http://www.nlm.nih.gov/medlineplus/vitaminandmineralsupplements.html

Within the health topic page dedicated to lactose intolerance, the following was listed: •

Diagnosis/Symptoms Hydrogen Breath Test Source: Cleveland Clinic Foundation http://www.clevelandclinic.org/health/healthinfo/docs/2800/2827.asp?index=10347

•

From the National Institutes of Health Why Does Milk Bother Me? Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/lactoseintolerance_ez/index.htm

•

Organizations American Gastroenterological Association http://www.gastro.org/ National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov/

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You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on lactose intolerance. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Lactose Intolerance Source: Bethesda, MD: American Gastroenterological Association. 199x. [4 p.]. Contact: American Gastroenterological Association (AGA). 7910 Woodmont Avenue, Seventh Floor, Bethesda, MD 20814. (800) 668-5237 or (301) 654-2055. Fax (301) 652-3890. Website: www.gastro.org. PRICE: Single copy free; bulk copies available. Summary: Lactose intolerance is the inability to digest significant amounts of lactose, which is the predominant sugar of milk. This brochure from the American Gastroenterological Association (AGA) reviews the problem of lactose intolerance. People who have trouble digesting lactose can learn, by testing themselves, which dairy products and other foods they can eat without discomfort and which ones they should avoid. Topics include a description of lactose intolerance and its causes, diagnostic tests used to confirm the condition, and treatment options. Common symptoms of lactose intolerance include nausea, cramps, bloating, gas, and diarrhea, which begin 30 minutes to two hours after eating or drinking foods containing lactose. The severity of symptoms varies depending on the amount of lactose each individual can tolerate. The most common tests used to measure the absorption of lactose in the digestive system are the lactose intolerance test, the hydrogen breath test, and the stool acidity test. Many people with lactose intolerance can enjoy milk, ice cream, and other such products if they take them in small amounts or eat other kinds of food at the same time. Others can use lactase liquid or tablets to help digest the lactose. Even older women and children who must avoid milk and foods made with milk can meet most of their special dietary needs by eating greens, fish, and other calcium rich foods that are free of lactose. A carefully chosen diet (with calcium supplements if the doctor recommends them) is the key to reducing symptoms and protecting future health. The brochure includes a diagram of the digestive tract, with organs labeled. 1 figure. 4 references.

•

Lactose Intolerance in Children Source: Flourtown, PA: American Society for Pediatric Gastroenterology, Hepatology and Nutrition. 2003. 1 p.

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Contact: Available from North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). PO Box 6, Flourtown, PA 19031. (215) 2330808. Fax: (215) 233-3939. Website: www.naspgn.org. PRICE: Full-text available online at no charge; contact organization for print copies. Summary: Lactose intolerance occurs when a person's intestine does not make enough lactase (an enzyme) to digest the lactose (milk sugar) that he or she eats. When undigested lactose reaches the colon (large intestine), it becomes food for the normal bacteria living there. The resulting gas and acid can cause symptoms of pain, bloating, excess gas, nausea, and diarrhea. This brief fact sheet considers lactose intolerance in children. The fact sheet defines the condition, then discusses its incidence (how common it is), the causes of the condition, diagnostic tests used to identify and confirm the problem, and treatment options. The author notes that most children will be able to tolerate some lactose and can do well with a low-lactose diet. There are also over the counter lactase pills or drops that help digest lactose. For more information, readers are encouraged to visit www.naspghan.org (the web site of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition). •

Lactose Intolerance: A Problem with Dairy Foods Source: San Bruno, CA: StayWell Company. 1998. [2 p.]. Contact: Available from StayWell Company. Order Department, 1100 Grundy Lane, San Bruno, CA 94066-9821. (800) 333-3032. Fax (650) 244-4512. PRICE: $ 17.95 for 50 copies; plus shipping and handling; bulk copies available. Order number 9782. Summary: This brochure describes lactose intolerance, a condition in which the person cannot digest lactose, a sugar found in milk and other dairy products. Undigested lactose is not harmful, but it can cause unpleasant symptoms. People who are lactose intolerant may notice the following symptoms about an hour or more after eating and drinking dairy products: gas or bloating, abdominal cramps and pain, rumbling stomach, and diarrhea. Diagnostic tests used to confirm lactose intolerance include a lactose intolerance test, breath test, stool test, or blood test. The brochure outlines strategies for people wishing to reduce symptoms, including choosing low lactose dairy products, eating foods with active cultures (such as yogurt), eating or drinking dairy products in conjunction with other foods, substituting fruit juice for milk in recipes, taking lactase enzyme tablets when ingesting dairy products, and avoiding eating many high lactose foods (such as milk, cream, butter, and ice cream) at one time. The brochure also offers a chart of nondairy substitutes for common dairy products. One section reminds readers that if they are cutting down on dairy products, then they must replace the calcium in their diet with other foods. A list of high calcium, dairy free foods is provided. A final section encourages readers to consult nutrition labels to determine the presence of lactose in a food product. The brochure is illustrated with full color drawings. 6 figures.

•

Article and Recipe Reprints Available from The Newsletter for People with Lactose Intolerance Source: Iowa City, IA: Newsletter for People with Lactose Intolerance. 2 p. Contact: Available from Jane Zukin. C/O Commercial Writing and Design, P.O. Box 3129, Ann Arbor, MI 48106-3129. Summary: This fact sheet lists article and recipe reprints available from a newsletter for individuals with lactose intolerance. Article topics include fast food restaurants, Eden

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Foods, ice cream alternatives, galactosemia, colo-rectal cancer, and secondary lactose intolerance. Recipes range from corn chowder and oriental chicken salad to tofu cheesecake and apple spice cupcakes. An order form and newsletter subscription information are provided. •

Lactose Intolerance (Milk Intolerance; Lactase Deficiency) Source: in Griffith, H.W. Instructions for Patients. 5th ed. Philadelphia, PA: W.B. Saunders Company. 1994. p. 267. Contact: Available from W.B. Saunders Company. Book Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887-4430. (800) 545-2522. Fax (800) 874-6418. PRICE: $49.95. ISBN: 0721649300 (English); 0721669972 (Spanish). Summary: This fact sheet provides basic information on frequent signs and symptoms, causes, risk factors, preventive measures, etc.; treatment, medication, and diet; and when to contact one's health care provider. The fact sheet is designed to be photocopied and distributed to patients as a reinforcement of oral instructions and as a teaching tool. The book in which the fact sheet appears is available in English or Spanish.

•

Lactose Intolerance: Definition, Clinical Features and Treatment Source: Milwaukee, WI: International Foundation for Functional Gastrointestinal Disorders (IFFGD). 1996. 2 p. Contact: Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217. (888) 964-2001 or (414) 9641799. Fax (414) 964-7176. E-mail: [email protected]. Website: www.iffgd.org. PRICE: Single copy free; bulk copies available. Summary: This fact sheet summarizes the epidemiology, symptoms, diagnosis, and treatment of lactose intolerance. Lactose intolerance is the development of gastrointestinal symptoms following the ingestion of milk or dairy products. The term should not be confused with lactase deficiency, which is a complete lack of or very markedly reduced levels of lactase, an enzyme normally present in the small intestine. The author stresses that symptoms of lactose intolerance may mimic those of other intestinal disorders. Lactose intolerance should be considered as a possible diagnosis in persons with diarrhea, bloating, and abdominal discomfort after meals. Eliminating lactose from the diet or supplementing the diet with lactase enzyme preparations or lactase containing milk products may reduce the symptoms. (AA-M).

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Healthfinder™ Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •

Lactose Intolerance Summary: Frequently asked questions about lactose intolerance, the inability to digest significant amounts of lactose, the predominant sugar of milk. Source: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6299 The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to lactose intolerance. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to lactose intolerance. By consulting all of associations

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listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with lactose intolerance. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about lactose intolerance. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “lactose intolerance” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “lactose intolerance”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “lactose intolerance” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “lactose intolerance” (or a synonym) into the search box, and click “Submit Query.”

111

APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.22

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

22

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

112 Lactose Intolerance

libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)23: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

23

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

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•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

114 Lactose Intolerance

•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

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•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

116 Lactose Intolerance

•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

117

ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on lactose intolerance: •

Basic Guidelines for Lactose Intolerance AIDS Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000594.htm Lactose intolerance Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000276.htm

•

Signs & Symptoms for Lactose Intolerance Abdominal bloating Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003123.htm Abdominal cramping Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm Abdominal cramps Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm

118 Lactose Intolerance

Abdominal distention Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003122.htm Abdominal fullness, gaseous Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003124.htm Bloating Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003123.htm Diarrhea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003126.htm Flatulence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003124.htm Growth, slow (child 0-5 years) Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003021.htm Nausea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Stools - floating Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003128.htm Stools - foul smelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003132.htm Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Weight loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003107.htm •

Diagnostics and Tests for Lactose Intolerance ALT Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003473.htm Biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003416.htm Differential Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003657.htm Lactose tolerance test Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003500.htm PRA Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003698.htm Small bowel biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003889.htm

Online Glossaries 119

•

Nutrition for Lactose Intolerance Protein Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002467.htm Riboflavin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002411.htm Vitamin D Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002405.htm Yogurt Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002463.htm

•

Background Topics for Lactose Intolerance Enzyme Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002353.htm Incidence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002387.htm Relieved by Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002288.htm

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

121

LACTOSE INTOLERANCE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Cramps: Abdominal pain due to spasmodic contractions of the bowel. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Abscess: A localized, circumscribed collection of pus. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adhesions: Pathological processes consisting of the union of the opposing surfaces of a wound. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aetiology: Study of the causes of disease. [EU] Agarose: A polysaccharide complex, free of nitrogen and prepared from agar-agar which is produced by certain seaweeds (red algae). It dissolves in warm water to form a viscid solution. [NIH] Age Groups: Persons classified by age from birth (infant, newborn) to octogenarians and older (aged, 80 and over). [NIH]

122 Lactose Intolerance

Aged, 80 and Over: A person 80 years of age and older. [NIH] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Anal Fissure: A small tear in the anus that may cause itching, pain, or bleeding. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]

Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anthropology: The science devoted to the comparative study of man. [NIH]

Dictionary 123

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-infective: An agent that so acts. [EU] Anti-Infective Agents: Substances that prevent infectious agents or organisms from spreading or kill infectious agents in order to prevent the spread of infection. [NIH] Antioxidants: Naturally occurring or synthetic substances that inhibit or retard the oxidation of a substance to which it is added. They counteract the harmful and damaging effects of oxidation in animal tissues. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Aorta: The main trunk of the systemic arteries. [NIH] Aortic Aneurysm: Aneurysm of the aorta. [NIH] Appendicitis: Acute inflammation of the vermiform appendix. [NIH] Approximate: Approximal [EU] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Aspartame: Flavoring agent sweeter than sugar, metabolized as phenylalanine and aspartic acid. [NIH] Aspartic: The naturally occurring substance is L-aspartic acid. One of the acidic-amino-acids is obtained by the hydrolysis of proteins. [NIH] Aspartic Acid: One of the non-essential amino acids commonly occurring in the L-form. It is found in animals and plants, especially in sugar cane and sugar beets. It may be a neurotransmitter. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury

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to the red nucleus; and other conditions. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autoimmunity: Process whereby the immune system reacts against the body's own tissues. Autoimmunity may produce or be caused by autoimmune diseases. [NIH] Autosuggestion: Suggestion coming from the subject himself. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Belching: Noisy release of gas from the stomach through the mouth. Also called burping. [NIH]

Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Beta-Galactosidase: A group of enzymes that catalyzes the hydrolysis of terminal, nonreducing beta-D-galactose residues in beta-galactosides. Deficiency of beta-Galactosidase A1 may cause gangliodisosis GM1. EC 3.2.1.23. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH]

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Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Composition: The relative amounts of various components in the body, such as percent body fat. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Regions: Anatomical areas of the body. [NIH] Bone Density: The amount of mineral per square centimeter of bone. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by photon absorptiometry or x-ray computed tomography. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder) and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a

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pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Campylobacter: A genus of bacteria found in the reproductive organs, intestinal tract, and oral cavity of animals and man. Some species are pathogenic. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Carcinoid: A type of tumor usually found in the gastrointestinal system (most often in the appendix), and sometimes in the lungs or other sites. Carcinoid tumors are usually benign. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Cataracts: In medicine, an opacity of the crystalline lens of the eye obstructing partially or totally its transmission of light. [NIH] Cecum: The beginning of the large intestine. The cecum is connected to the lower part of the small intestine, called the ileum. [NIH] Celiac Disease: A disease characterized by intestinal malabsorption and precipitated by

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gluten-containing foods. The intestinal mucosa shows loss of villous structure. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chelation: Combination with a metal in complexes in which the metal is part of a ring. [EU] Chemotherapy: Treatment with anticancer drugs. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Cholangitis: Inflammation of a bile duct. [NIH] Cholecystitis: Inflammation of the gallbladder. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic Fatigue Syndrome: Fatigue caused by the combined effects of different types of prolonged fatigue. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Claviceps: A genus of ascomycetous fungi, family Clavicipitaceae, order Hypocreales, parasitic on various grasses. The sclerotia contain several toxic alkaloids. Claviceps purpurea on rye causes ergotism. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH]

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Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colic: Paroxysms of pain. This condition usually occurs in the abdominal region but may occur in other body regions as well. [NIH] Colitis: Inflammation of the colon. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colloidal: Of the nature of a colloid. [EU] Colon Polyps: Small, fleshy, mushroom-shaped growths in the colon. [NIH] Colonic flora: The bacteria normally residing within the colon. [EU] Colonoscopy: Endoscopic examination, therapy or surgery of the luminal surface of the colon. [NIH] Colorectal: Having to do with the colon or the rectum. [NIH] Colorectal Cancer: Cancer that occurs in the colon (large intestine) or the rectum (the end of the large intestine). A number of digestive diseases may increase a person's risk of colorectal cancer, including polyposis and Zollinger-Ellison Syndrome. [NIH] Colostomy: An opening into the colon from the outside of the body. A colostomy provides a new path for waste material to leave the body after part of the colon has been removed. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in

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addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU]

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Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclic Vomiting Syndrome: Sudden, repeated attacks of severe vomiting (especially in children), nausea, and physical exhaustion with no apparent cause. Can last from a few hours to 10 days. The episodes begin and end suddenly. Loss of fluids in the body and changes in chemicals in the body can require immediate medical attention. Also called abdominal migraine. [NIH] Cytotoxic: Cell-killing. [NIH] Cytotoxic chemotherapy: Anticancer drugs that kill cells, especially cancer cells. [NIH] Dairy Products: Raw and processed or manufactured milk and milk-derived products. These are usually from cows (bovine) but are also from goats, sheep, reindeer, and water buffalo. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Day Care: Institutional health care of patients during the day. The patients return home at night. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. [NIH] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Developed Countries: Countries that have reached a level of economic achievement through an increase of production, per capita income and consumption, and utilization of natural and human resources. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diarrhoea: Abnormal frequency and liquidity of faecal discharges. [EU]

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Diastolic: Of or pertaining to the diastole. [EU] Dietary Fats: Fats present in food, especially in animal products such as meat, meat products, butter, ghee. They are present in lower amounts in nuts, seeds, and avocados. [NIH]

Dietary Fiber: The remnants of plant cell walls that are resistant to digestion by the alimentary enzymes of man. It comprises various polysaccharides and lignins. [NIH] Dietetics: The study and regulation of the diet. [NIH] Dietitian: An expert in nutrition who helps people plan what and how much food to eat. [NIH]

Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dilution: A diluted or attenuated medicine; in homeopathy, the diffusion of a given quantity of a medicinal agent in ten or one hundred times the same quantity of water. [NIH] Dimethyl: A volatile metabolite of the amino acid methionine. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Distention: The state of being distended or enlarged; the act of distending. [EU] Diuresis: Increased excretion of urine. [EU] Diuretic: A drug that increases the production of urine. [NIH] Diverticula: Plural form of diverticulum. [NIH] Diverticulitis: Inflammation of a diverticulum or diverticula. [NIH] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Dumping Syndrome: Gastrointestinal nonfunctioning pylorus. [NIH]

symptoms

Duodenum: The first part of the small intestine. [NIH]

resulting

from

an

absent

or

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Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysphagia: Difficulty in swallowing. [EU] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dyspnea: Difficult or labored breathing. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Ectopic: Pertaining to or characterized by ectopia. [EU] Ectopic Pregnancy: The pregnancy occurring elsewhere than in the cavity of the uterus. [NIH]

Eczema: A pruritic papulovesicular dermatitis occurring as a reaction to many endogenous and exogenous agents (Dorland, 27th ed). [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Effusion: The escape of fluid into a part or tissue, as an exudation or a transudation. [EU] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]

Emergency Medicine: A branch of medicine concerned with an individual's resuscitation, transportation and care from the point of injury or beginning of illness through the hospital or other emergency treatment facility. [NIH] Emergency Treatment: First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enteral Nutrition: Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes. [NIH] Enteritis: Inflammation of the intestine, applied chiefly to inflammation of the small intestine; see also enterocolitis. [EU] Enterocolitis: Inflammation of the intestinal mucosa of the small and large bowel. [NIH] Enterocytes: Terminally differentiated cells comprising the majority of the external surface of the intestinal epithelium (see intestinal mucosa). Unlike goblet cells, they do not produce or secrete mucins, nor do they secrete cryptdins as do the paneth cells. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health.

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[NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelial ovarian cancer: Cancer that occurs in the cells lining the ovaries. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Ergot: Cataract due to ergot poisoning caused by eating of rye cereals contaminated by a fungus. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. [NIH] Evacuation: An emptying, as of the bowels. [EU] Excipients: Usually inert substances added to a prescription in order to provide suitable consistency to the dosage form; a binder, matrix, base or diluent in pills, tablets, creams, salves, etc. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expiration: The act of breathing out, or expelling air from the lungs. [EU] Exudate: Material, such as fluid, cells, or cellular debris, which has escaped from blood vessels and has been deposited in tissues or on tissue surfaces, usually as a result of inflammation. An exudate, in contrast to a transudate, is characterized by a high content of protein, cells, or solid materials derived from cells. [EU]

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Faecal: Pertaining to or of the nature of feces. [EU] Failure to Thrive: A condition in which an infant or child's weight gain and growth are far below usual levels for age. [NIH] Family Health: The health status of the family as a unit including the impact of the health of one member of the family on the family as a unit and on individual family members; also, the impact of family organization or disorganization on the health status of its members. [NIH]

Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Febrile: Pertaining to or characterized by fever. [EU] Fecal Incontinence: Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fermentation: An enzyme-induced chemical change in organic compounds that takes place in the absence of oxygen. The change usually results in the production of ethanol or lactic acid, and the production of energy. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fish Products: Food products manufactured from fish (e.g., fish flour, fish meal). [NIH] Fistulas: An abnormal passage from one hollow structure of the body to another, or from a hollow structure to the surface, formed by an abscess, disease process, incomplete closure of a wound, or by a congenital anomaly. [NIH] Flatulence: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus. [NIH] Flatus: Gas passed through the rectum. [NIH] Flavoring Agents: Substances added to foods and medicine to improve the quality of taste. [NIH]

Fluid Therapy: Therapy whose basic objective is to restore the volume and composition of the body fluids to normal with respect to water-electrolyte balance. Fluids may be administered intravenously, orally, by intermittent gavage, or by hypodermoclysis. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH]

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Food Additives: Substances which are of little or no nutritive value, but are used in the processing or storage of foods or animal feed, especially in the developed countries; includes antioxidants, food preservatives, food coloring agents, flavoring agents, anti-infective agents (both plain and local), vehicles, excipients and other similarly used substances. Many of the same substances are pharmaceutic aids when added to pharmaceuticals rather than to foods. [NIH]

Food Coloring Agents: Natural or synthetic dyes used as coloring agents in processed foods. [NIH] Food Labeling: Use of written, printed, or graphic materials upon or accompanying a food or its container or wrapper. The concept includes ingredients, nutritional value, directions, warnings, and other relevant information. [NIH] Food Preservatives: Substances capable of inhibiting, retarding or arresting the process of fermentation, acidification or other deterioration of foods. [NIH] Foodborne Illness: An acute gastrointestinal infection caused by food that contains harmful bacteria. Symptoms include diarrhea, abdominal pain, fever, and chills. Also called food poisoning. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fructose: A type of sugar found in many fruits and vegetables and in honey. Fructose is used to sweeten some diet foods. It is considered a nutritive sweetener because it has calories. [NIH] Fructose Intolerance: An autosomal recessive fructose metabolism disorder due to deficient fructose-1-phosphate aldolase (EC 2.1.2.13) activity, resulting in accumulation of fructose-1phosphate. The accumulated fructose-1-phosphate inhibits glycogenolysis and gluconeogenesis, causing severe hypoglycemia following ingestion of fructose. Prolonged fructose ingestion in infants leads ultimately to hepatic failure and death. Patients develop a strong distaste for sweet food, and avoid a chronic course of the disease by remaining on a fructose- and sucrose-free diet. [NIH] Functional Disorders: Disorders such as irritable bowel syndrome. These conditions result from poor nerve and muscle function. Symptoms such as gas, pain, constipation, and diarrhea come back again and again, but there are no signs of disease or damage. Emotional stress can trigger symptoms. Also called motility disorders. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Galactosemia: Buildup of galactose in the blood. Caused by lack of one of the enzymes needed to break down galactose into glucose. [NIH] Galactosides: Glycosides formed by the reaction of the hydroxyl group on the anomeric carbon atom of galactose with an alcohol to form an acetal. They include both alpha- and beta-galactosides. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored

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in the gallbladder. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrectomy: An operation to remove all or part of the stomach. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Emptying: The evacuation of food from the stomach into the duodenum. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastritis: Inflammation of the stomach. [EU] Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastroenterologist: A doctor who specializes in diagnosing and treating disorders of the digestive system. [NIH] Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastroesophageal Reflux Disease: Flow of the stomach's contents back up into the esophagus. Happens when the muscle between the esophagus and the stomach (the lower esophageal sphincter) is weak or relaxes when it shouldn't. May cause esophagitis. Also called esophageal reflux or reflux esophagitis. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gastroparesis: Nerve or muscle damage in the stomach. Causes slow digestion and emptying, vomiting, nausea, or bloating. Also called delayed gastric emptying. [NIH] Gastrostomy: Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH]

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Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Gluconeogenesis: The process by which glucose is formed from a non-carbohydrate source. [NIH]

Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]

Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Goats: Any of numerous agile, hollow-horned ruminants of the genus Capra, closely related to the sheep. [NIH] Goblet Cells: Cells of the epithelial lining that produce and secrete mucins. [NIH] Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Government Agencies: Administrative units of government responsible for policy making and management of governmental activities in the U.S. and abroad. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Groin: The external junctural region between the lower part of the abdomen and the thigh. [NIH]

Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Happiness: Highly pleasant emotion characterized by outward manifestations of gratification; joy. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs,

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and access to medical care. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hernia: Protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [NIH]

Hiatal Hernia: A small opening in the diaphragm that allows the upper part of the stomach to move up into the chest. Causes heartburn from stomach acid flowing back up through the opening. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Homeopathic remedies: Small doses of medicines, herbs, or both that are believed to stimulate the immune system. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless,

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odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Breath Test: A test for lactose intolerance. It measures breath samples for too much hydrogen. The body makes too much hydrogen when lactose is not broken down properly in the small intestine. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypoglycemia: Abnormally low blood sugar [NIH] Iatrogenic: Resulting from the activity of physicians. Originally applied to disorders induced in the patient by autosuggestion based on the physician's examination, manner, or discussion, the term is now applied to any adverse condition in a patient occurring as the result of treatment by a physician or surgeon, especially to infections acquired by the patient during the course of treatment. [EU] Ice Cream: A frozen dairy food made from cream or butterfat, milk, sugar, and flavorings. Frozen custard and French-type ice creams also contain eggs. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Ileal: Related to the ileum, the lowest end of the small intestine. [NIH] Ileostomy: Surgical creation of an external opening into the ileum for fecal diversion or drainage. Loop or tube procedures are most often employed. [NIH] Ileum: The lower end of the small intestine. [NIH] Ileus: Obstruction of the intestines. [EU] Imaging procedures: Methods of producing pictures of areas inside the body. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodiffusion: Technique involving the diffusion of antigen or antibody through a semisolid medium, usually agar or agarose gel, with the result being a precipitin reaction. [NIH]

Immunoelectrophoresis: A technique that combines protein electrophoresis and double immunodiffusion. In this procedure proteins are first separated by gel electrophoresis (usually agarose), then made visible by immunodiffusion of specific antibodies. A distinct elliptical precipitin arc results for each protein detectable by the antisera. [NIH] Immunoglobulins: Glycoproteins present in the blood (antibodies) and in other tissue. They are classified by structure and activity into five classes (IgA, IgD, IgE, IgG, IgM). [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of

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psychological, physiological, or anatomical structure or function. [NIH] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indigestion: Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia. [NIH] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infant, Newborn: An infant during the first month after birth. [NIH] Infantile: Pertaining to an infant or to infancy. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infectious Diarrhea: Diarrhea caused by infection from bacteria, viruses, or parasites. [NIH] Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]

Ingestion: Taking into the body by mouth [NIH] Inguinal: Pertaining to the inguen, or groin. [EU] Inhalation: The drawing of air or other substances into the lungs. [EU] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestinal Obstruction: Any impairment, arrest, or reversal of the normal flow of intestinal

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contents toward the anus. [NIH] Intestinal Pseudo-Obstruction: Obstruction of the intestines that is functional, not mechanical. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]

Jejunostomy: Surgical formation of an opening through the abdominal wall into the jejunum, usually for enteral hyperalimentation. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Lactose Intolerance: The disease state resulting from the absence of lactase enzyme in the musocal cells of the gastrointestinal tract, and therefore an inability to break down the disaccharide lactose in milk for absorption from the gastrointestinal tract. It is manifested by indigestion of a mild nature to severe diarrhea. It may be due to inborn defect genetically conditioned or may be acquired. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Lesion: An area of abnormal tissue change. [NIH]

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Leukemia: Cancer of blood-forming tissue. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Linkages: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Loperamide: 4-(p-Chlorophenyl)-4-hydroxy-N.N-dimethyl-alpha,alpha-diphenyl-1piperidine butyramide hydrochloride. Synthetic anti-diarrheal agent with a long duration of action; it is not significantly absorbed from the gut, has no effect on the adrenergic system or central nervous system, but may antagonize histamine and interfere with acetylcholine release locally. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]

Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malabsorption syndrome: A group of symptoms such as gas, bloating, abdominal pain, and diarrhea resulting from the body's inability to properly absorb nutrients. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]

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Meat Products: Articles of food which are derived by a process of manufacture from any portion of carcasses of any animal used for food (e.g., head cheese, sausage, scrapple). [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Megacolon: Pathological enlargement of the colon. [NIH] Megaloblastic: A large abnormal red blood cell appearing in the blood in pernicious anaemia. [EU] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Milliliter: A measure of volume for a liquid. A milliliter is approximately 950-times smaller than a quart and 30-times smaller than a fluid ounce. A milliliter of liquid and a cubic centimeter (cc) of liquid are the same. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other

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forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Nasogastric: The process of passing a small, flexible plastic tube through the nose or mouth into the stomach or small intestine. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neuromuscular: Pertaining to muscles and nerves. [EU] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14.

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Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nutritional Status: State of the body in relation to the consumption and utilization of nutrients. [NIH] Nutritional Support: The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include fluid therapy which normalizes body fluids to restore water-electrolyte balance. [NIH] Nutritive Value: An indication of the contribution of a food to the nutrient content of the diet. This value depends on the quantity of a food which is digested and absorbed and the amounts of the essential nutrients (protein, fat, carbohydrate, minerals, vitamins) which it contains. This value can be affected by soil and growing conditions, handling and storage, and processing. [NIH] Occupational Medicine: Medical specialty concerned with the promotion and maintenance of the physical and mental health of employees in occupational settings. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Ondansetron: A competitive serotonin type 3 receptor antagonist. It is effective in the treatment of nausea and vomiting caused by cytotoxic chemotherapy drugs, including cisplatin, and it has reported anxiolytic and neuroleptic properties. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Osmosis: Tendency of fluids (e.g., water) to move from the less concentrated to the more concentrated side of a semipermeable membrane. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Pancreatic Insufficiency: Absence of or reduced pancreatic exocrine secretion into the duodenum and resultant poor digestion of lipids, vitamins, nitrogen, and carbohydrates. [NIH]

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Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Paneth Cells: Epithelial cells found in the basal part of the intestinal glands (crypts of Lieberkuhn). Paneth cells synthesize and secrete lysozyme and cryptdins. [NIH] Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pediatrics: A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: Ulcer that occurs in those portions of the alimentary tract which come into contact with gastric juice containing pepsin and acid. It occurs when the amount of acid and pepsin is sufficient to overcome the gastric mucosal barrier. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perimenopausal: The time of a woman's life when menstrual periods become irregular. Refers to the time near menopause. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Peritonitis: Inflammation of the peritoneum; a condition marked by exudations in the peritoneum of serum, fibrin, cells, and pus. It is attended by abdominal pain and tenderness, constipation, vomiting, and moderate fever. [EU] Pernicious: Tending to a fatal issue. [EU] Pernicious anemia: A type of anemia (low red blood cell count) caused by the body's

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inability to absorb vitamin B12. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Pharmaceutic Aids: Substances which are of little or no therapeutic value, but are necessary in the manufacture, compounding, storage, etc., of pharmaceutical preparations or drug dosage forms. They include solvents, diluting agents, and suspending agents, and emulsifying agents. Also, antioxidants; preservatives, pharmaceutical; dyes (coloring agents); flavoring agents; vehicles; excipients; ointment bases. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Placebo Effect: An effect usually, but not necessarily, beneficial that is attributable to an expectation that the regimen will have an effect, i.e., the effect is due to the power of suggestion. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU]

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Pleura: The thin serous membrane enveloping the lungs and lining the thoracic cavity. [NIH] Pleurisy: Inflammation of the pleura, with exudation into its cavity and upon its surface. It may occur as either an acute or a chronic process. In acute pleurisy the pleura becomes reddened, then covered with an exudate of lymph, fibrin, and cellular elements (the dry stage); the disease may progress to the second stage, in which a copious exudation of serum occurs (stage of liquid effusion). The inflamed surfaces of the pleura tend to become united by adhesions, which are usually permanent. The symptoms are a stitch in the side, a chill, followed by fever and a dry cough. As effusion occurs there is an onset of dyspnea and a diminution of pain. The patient lies on the affected side. [EU] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Policy Making: The decision process by which individuals, groups or institutions establish policies pertaining to plans, programs or procedures. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polyposis: The development of numerous polyps (growths that protrude from a mucous membrane). [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postprandial: Occurring after dinner, or after a meal; postcibal. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Premenstrual: Occurring before menstruation. [EU] Premenstrual Syndrome: A syndrome occurring most often during the last week of the menstrual cycle and ending soon after the onset of menses. Some of the symptoms are emotional instability, insomnia, headache, nausea, vomiting, abdominal distension, and painful breasts. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH]

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Proctosigmoiditis: Irritation of the rectum and the sigmoid colon. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Protein-Energy Malnutrition: The lack of sufficient energy or protein to meet the body's metabolic demands, as a result of either an inadequate dietary intake of protein, intake of poor quality dietary protein, increased demands due to disease, or increased nutrient losses. [NIH]

Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pruritic: Pertaining to or characterized by pruritus. [EU] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Putrefaction: The process of decomposition of animal and vegetable matter by living organisms. [NIH] Pylorus: The opening in a vertebrate from the stomach into the intestine. [EU] Quackery: The fraudulent misrepresentation of the diagnosis and treatment of disease. [NIH]

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Radioactive: Giving off radiation. [NIH] Radioisotope: An unstable element that releases radiation as it breaks down. Radioisotopes can be used in imaging tests or as a treatment for cancer. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Resuscitation: The restoration to life or consciousness of one apparently dead; it includes such measures as artificial respiration and cardiac massage. [EU] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retinoids: Derivatives of vitamin A. Used clinically in the treatment of severe cystic acne, psoriasis, and other disorders of keratinization. Their possible use in the prophylaxis and treatment of cancer is being actively explored. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH]

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Rye: A hardy grain crop, Secale cereale, grown in northern climates. It is the most frequent host to ergot (claviceps), the toxic fungus. Its hybrid with wheat is triticale, another grain. [NIH]

Saccharin: Flavoring agent and non-nutritive sweetener. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Seafood: Marine fish and shellfish used as food or suitable for food. (Webster, 3d ed) shellfish and fish products are more specific types of seafood. [NIH] Secretin: A hormone made in the duodenum. Causes the stomach to make pepsin, the liver to make bile, and the pancreas to make a digestive juice. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important

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physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Short Bowel Syndrome: A malabsorption syndrome resulting from extensive operative resection of small bowel. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Sigmoid: 1. Shaped like the letter S or the letter C. 2. The sigmoid colon. [EU] Sigmoid Colon: The lower part of the colon that empties into the rectum. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Sorbitol: A polyhydric alcohol with about half the sweetness of sucrose. Sorbitol occurs naturally and is also produced synthetically from glucose. It was formerly used as a diuretic and may still be used as a laxative and in irrigating solutions for some surgical procedures. It is also used in many manufacturing processes, as a pharmaceutical aid, and in several research applications. [NIH] Spasmodic: Of the nature of a spasm. [EU] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in

Dictionary 153

spastic paralysis or in cerebral palsy. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Sprue: A non febrile tropical disease of uncertain origin. [NIH] Statistically significant: Describes a mathematical measure of difference between groups. The difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone. [NIH] Steatorrhea: A condition in which the body cannot absorb fat. Causes a buildup of fat in the stool and loose, greasy, and foul bowel movements. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Steroid therapy: Treatment with corticosteroid drugs to reduce swelling, pain, and other symptoms of inflammation. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stomach Ulcer: An open sore in the lining of the stomach. Also called gastric ulcer. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stool test: A test to check for hidden blood in the bowel movement. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by

154 Lactose Intolerance

clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Supplementation: Adding nutrients to the diet. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures

Dictionary 155

preparatory to specified dental therapeutic and surgical measures. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Tracer: A substance (such as a radioisotope) used in imaging procedures. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trichomoniasis: An infection with the protozoan parasite Trichomonas vaginalis. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation

156 Lactose Intolerance

due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Varices: Stretched veins such as those that form in the esophagus from cirrhosis. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Veins: The vessels carrying blood toward the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Vertebral: Of or pertaining to a vertebra. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villi: The tiny, fingerlike projections on the surface of the small intestine. Villi help absorb nutrients. [NIH] Villous: Of a surface, covered with villi. [NIH] Viruses: Minute infectious agents whose genomes are composed of DNA or RNA, but not both. They are characterized by a lack of independent metabolism and the inability to replicate outside living host cells. [NIH] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] Weight-Bearing: The physical state of supporting an applied load. This often refers to the weight-bearing bones or joints that support the body's weight, especially those in the spine, hip, knee, and foot. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH]

157

INDEX A Abdomen, 72, 121, 125, 133, 137, 141, 142, 145, 153, 154 Abdominal Cramps, 106, 121 Abdominal Pain, 4, 6, 38, 39, 40, 60, 64, 69, 71, 72, 73, 74, 121, 135, 136, 141, 142, 146, 155 Abscess, 121, 134 Acetylcholine, 121, 142 Adaptation, 5, 15, 37, 53, 89, 121 Adenosine, 121, 126, 147 Adhesions, 121, 148 Adjustment, 121 Adolescence, 121, 146 Adrenergic, 121, 142 Adverse Effect, 77, 121, 152 Aetiology, 18, 19, 121 Agarose, 121, 139 Age Groups, 6, 63, 79, 121 Aged, 80 and Over, 121, 122 Albumin, 73, 122, 147 Alertness, 122, 126 Algorithms, 122, 125 Alimentary, 41, 122, 131, 132, 146 Alkaline, 122, 126 Alternative medicine, 86, 122 Amenorrhea, 122 Amino Acids, 122, 123, 146, 149, 155 Ammonia, 122, 154, 155 Anal, 64, 65, 76, 77, 122, 134 Anal Fissure, 64, 65, 122 Anatomical, 122, 125, 140, 151 Anemia, 71, 78, 101, 122, 134, 146 Anions, 122, 141 Anorexia, 60, 64, 73, 122, 136, 155 Anorexia Nervosa, 64, 122 Antagonism, 122, 126 Anthropology, 78, 122 Antibodies, 123, 139 Antibody, 77, 123, 128, 139, 140 Antigen, 123, 128, 139, 140 Anti-infective, 123, 135 Anti-Infective Agents, 123, 135 Antioxidants, 123, 135, 147 Anus, 76, 122, 123, 125, 134, 141, 150 Anxiety, 4, 71, 123 Anxiolytic, 123, 145 Aorta, 123

Aortic Aneurysm, 72, 123 Appendicitis, 65, 66, 72, 75, 76, 77, 123 Approximate, 6, 123 Arterial, 123, 139, 149, 154 Arteries, 123, 125, 129, 143 Aspartame, 6, 74, 123 Aspartic, 123 Aspartic Acid, 123 Assay, 60, 123 Asymptomatic, 20, 123, 146 Ataxia, 101, 123, 154 Atrophy, 100, 101, 124 Attenuated, 124, 131 Autodigestion, 124, 146 Autoimmune disease, 124 Autoimmunity, 49, 124 Autosuggestion, 124, 139 B Bacteria, 52, 59, 74, 106, 123, 124, 126, 128, 133, 134, 135, 136, 140, 143, 156 Bacterial Physiology, 121, 124 Basal Ganglia, 123, 124 Basal Ganglia Diseases, 123, 124 Base, 124, 130, 133, 141, 155 Belching, 71, 73, 124 Benign, 64, 124, 126, 137 Beta-Galactosidase, 52, 124 Bile, 124, 127, 135, 136, 141, 142, 151, 153 Bile Acids, 124, 136, 153 Bile Ducts, 124, 136 Bile Pigments, 124, 141 Biliary, 75, 124, 146 Biliary Tract, 124, 146 Bilirubin, 122, 124, 136, 139 Biopsy, 4, 69, 77, 82, 118, 125 Biosynthesis, 13, 125 Biotechnology, 11, 67, 86, 97, 99, 100, 101, 102, 125 Bladder, 125, 140, 149, 155 Bloating, 5, 6, 8, 59, 60, 69, 73, 80, 82, 88, 105, 106, 107, 117, 118, 125, 136, 140, 141, 142 Blood Cell Count, 125, 146 Blood Coagulation, 125, 126 Blood Glucose, 125, 138, 140 Blood pressure, 70, 82, 125, 139, 152 Blood vessel, 125, 126, 133, 141, 142, 152, 154, 156

158 Lactose Intolerance

Body Composition, 52, 125 Body Fluids, 125, 131, 134, 145, 152 Body Regions, 125, 128 Bone Density, 10, 17, 125 Bowel Movement, 64, 125, 131, 153 Branch, 115, 125, 132, 142, 146, 153, 154 Breakdown, 73, 125, 131, 136 Buccal, 125, 142 Bulimia, 64, 125 Bypass, 80, 125 C Caffeine, 70, 79, 125 Calcium, 5, 7, 9, 10, 13, 14, 30, 40, 46, 48, 50, 66, 70, 76, 87, 88, 105, 106, 126, 128 Campylobacter, 37, 126 Capsules, 23, 60, 126 Carbohydrate, 6, 28, 69, 70, 126, 129, 137, 145 Carbon Dioxide, 61, 126, 150 Carcinogenic, 126, 153 Carcinogens, 126, 145 Carcinoid, 77, 126 Cardiac, 126, 136, 144, 150, 153 Cardiovascular, 79, 126, 152 Cardiovascular System, 79, 126 Case report, 126, 127 Case series, 126, 127 Cataracts, 15, 23, 126 Cecum, 126, 141 Celiac Disease, 55, 64, 65, 66, 69, 75, 76, 77, 78, 126 Cell, 100, 101, 124, 125, 127, 128, 130, 131, 135, 141, 143, 144, 145, 147, 150, 154, 156 Cell Division, 100, 124, 127, 147 Cell Respiration, 127, 150 Central Nervous System, 76, 77, 121, 126, 127, 137, 142, 151 Central Nervous System Infections, 127, 137 Cerebellar, 123, 127, 150 Cerebral, 123, 124, 127, 153 Cerebrum, 127, 155 Character, 127, 130, 137 Chelation, 12, 127 Chemotherapy, 6, 14, 127 Chest Pain, 73, 127 Cholangitis, 65, 127 Cholecystitis, 65, 127 Cholesterol, 64, 124, 127, 136, 153 Chronic Disease, 9, 10, 127 Chronic Fatigue Syndrome, 71, 127 Chronic renal, 127, 148, 155

Cisplatin, 127, 145 Claviceps, 127, 151 Clinical study, 40, 50, 127 Clinical trial, 10, 97, 127, 128, 149, 150 Cloning, 125, 128 Cofactor, 128, 149 Colic, 19, 67, 128 Colitis, 64, 70, 72, 73, 128, 141 Collapse, 125, 128 Colloidal, 122, 128, 132 Colon Polyps, 77, 128 Colonic flora, 5, 128 Colonoscopy, 82, 128 Colorectal, 64, 77, 128 Colorectal Cancer, 64, 77, 128 Colostomy, 66, 128 Complement, 128, 129, 147 Complementary and alternative medicine, 49, 56, 128 Complementary medicine, 49, 129 Complete remission, 129, 150 Computational Biology, 97, 99, 129 Concomitant, 54, 129 Connective Tissue, 129, 134 Constipation, 64, 65, 66, 69, 73, 75, 76, 77, 78, 129, 135, 141, 146 Consumption, 6, 11, 21, 35, 39, 59, 80, 89, 129, 130, 136, 145 Contraindications, ii, 129 Coronary, 129, 143 Coronary Thrombosis, 129, 143 Cortex, 123, 129, 149, 150 Corticosteroid, 129, 153 Cortisol, 122, 129 Cranial, 129, 130, 137 Craniocerebral Trauma, 124, 130, 137, 154 Curative, 130, 154 Cutaneous, 130, 142 Cyclic, 66, 126, 130 Cyclic Vomiting Syndrome, 66, 130 Cytotoxic, 130, 145 Cytotoxic chemotherapy, 130, 145 D Dairy Products, 4, 7, 9, 21, 59, 60, 67, 69, 73, 80, 88, 89, 105, 106, 107, 130 Databases, Bibliographic, 97, 130 Day Care, 66, 130 Degenerative, 130, 138 Dehydration, 71, 77, 130 Denaturation, 5, 130 Density, 7, 10, 13, 33, 125, 130, 145 Dermatitis, 17, 130, 132

Index 159

Deuterium, 130, 139 Developed Countries, 130, 135 Diabetes Mellitus, 69, 130, 137, 138 Diagnostic procedure, 4, 57, 65, 87, 130 Diaphragm, 130, 138 Diarrhoea, 17, 18, 20, 28, 30, 35, 39, 50, 52, 53, 130, 136 Diastolic, 131, 139 Dietary Fats, 82, 131 Dietary Fiber, 71, 131 Dietetics, 79, 80, 131 Dietitian, 6, 71, 76, 131 Diffusion, 131, 139 Digestive system, 7, 8, 59, 65, 66, 69, 73, 105, 131, 136 Digestive tract, 18, 65, 73, 76, 105, 131, 152 Dilution, 60, 131 Dimethyl, 131, 142 Direct, iii, 52, 91, 131, 150 Distal, 36, 131, 136, 149 Distention, 4, 71, 118, 131 Diuresis, 126, 131 Diuretic, 131, 152 Diverticula, 131 Diverticulitis, 64, 66, 77, 131 Diverticulum, 131 Drug Interactions, 92, 131 Drug Tolerance, 131, 154 Duct, 127, 131, 133, 151, 154 Dumping Syndrome, 70, 80, 131 Duodenum, 124, 131, 136, 145, 146, 151, 153 Dyspepsia, 42, 66, 132, 140 Dysphagia, 73, 75, 132 Dysplasia, 101, 132 Dyspnea, 132, 148 Dystrophy, 100, 132 E Ectopic, 72, 132 Ectopic Pregnancy, 72, 132 Eczema, 17, 74, 132 Efficacy, 5, 17, 52, 132 Effusion, 132, 148 Electrolyte, 129, 132, 134, 145, 148, 152, 155 Electrophoresis, 132, 139 Emergency Medicine, 64, 132 Emergency Treatment, 132 Endoscopy, 69, 77, 132 End-stage renal, 127, 132, 148 Enteral Nutrition, 50, 73, 132 Enteritis, 37, 132

Enterocolitis, 132 Enterocytes, 13, 132 Environmental Exposure, 132, 145 Environmental Health, 96, 98, 132 Enzymatic, 59, 126, 128, 133, 138 Enzyme, 5, 7, 8, 58, 59, 60, 82, 88, 89, 106, 107, 119, 133, 134, 141, 146, 147, 154 Epidemic, 89, 133, 153 Epigastric, 133, 145 Epithelial, 16, 46, 59, 133, 137, 138, 146 Epithelial Cells, 59, 133, 138 Epithelial ovarian cancer, 16, 46, 133 Epithelium, 132, 133, 136 Ergot, 133, 151 Erythema, 133, 155 Erythrocytes, 122, 125, 133, 150 Esophageal, 77, 133, 136 Esophagitis, 133, 136 Esophagus, 75, 77, 131, 133, 136, 138, 142, 147, 150, 153, 156 Essential Tremor, 101, 133 Ethanol, 133, 134 Ethnic Groups, 29, 89, 133 Evacuation, 129, 133, 136, 141 Excipients, 133, 135, 147 Exhaustion, 122, 130, 133 Exocrine, 69, 133, 145 Exogenous, 43, 132, 133 Expiration, 133, 150 Exudate, 133, 148 F Faecal, 130, 134 Failure to Thrive, 27, 134 Family Health, 77, 134 Family Planning, 97, 134 Fat, 6, 7, 36, 69, 72, 76, 79, 125, 129, 134, 142, 145, 152, 153 Fatigue, 69, 127, 134 Fatty acids, 73, 122, 134 Febrile, 134, 153 Fecal Incontinence, 75, 134, 140 Feces, 129, 134, 153 Fermentation, 5, 18, 134, 135 Fibrin, 125, 134, 146, 148 Fibrosis, 69, 101, 134, 151 Fish Products, 134, 151 Fistulas, 76, 134 Flatulence, 4, 5, 60, 73, 80, 82, 118, 134 Flatus, 134, 136 Flavoring Agents, 134, 135, 147 Fluid Therapy, 134, 145 Folate, 18, 76, 134

160 Lactose Intolerance

Folic Acid, 76, 134 Food Additives, 65, 135 Food Coloring Agents, 135 Food Labeling, 63, 69, 89, 135 Food Preservatives, 135 Foodborne Illness, 74, 81, 135 Forearm, 125, 135 Fructose, 72, 79, 135 Fructose Intolerance, 79, 135 Functional Disorders, 66, 71, 135 Fungi, 127, 135, 137, 143 Fungus, 133, 135, 151 G Galactosemia, 107, 135 Galactosides, 124, 135 Gallbladder, 72, 77, 82, 121, 124, 127, 131, 135, 136 Gallstones, 64, 65, 66, 72, 74, 75, 136 Gastrectomy, 19, 136 Gastric, 17, 66, 80, 124, 136, 138, 146, 153 Gastric Emptying, 17, 66, 136 Gastric Juices, 136, 146 Gastric Mucosa, 136, 146 Gastrin, 136, 138 Gastritis, 64, 65, 72, 75, 136 Gastroenteritis, 15, 27, 64, 77, 136 Gastroenterologist, 77, 82, 136 Gastroesophageal Reflux, 55, 66, 81, 136 Gastroesophageal Reflux Disease, 55, 66, 81, 136 Gastrointestinal tract, 70, 77, 79, 81, 133, 134, 136, 141, 151 Gastroparesis, 75, 136 Gastrostomy, 132, 136 Gene, 18, 67, 86, 101, 102, 125, 136, 145 Genetic testing, 77, 136 Genetics, 53, 63, 88, 136 Gland, 129, 137, 145, 149, 151, 154 Gluconeogenesis, 135, 137 Glucose, 5, 18, 37, 59, 60, 61, 82, 100, 125, 130, 135, 137, 138, 140, 151, 152 Glucose Intolerance, 130, 137 Glutamic Acid, 134, 137 Gluten, 63, 65, 69, 74, 75, 76, 77, 78, 127, 137 Goats, 130, 137 Goblet Cells, 132, 137 Gonadal, 137, 153 Governing Board, 137, 148 Government Agencies, 66, 137, 148 Graft, 137, 138 Grasses, 127, 134, 137

Groin, 137, 140 Growth, 5, 10, 59, 69, 100, 118, 121, 122, 134, 137, 142, 144, 145, 147 H Happiness, 77, 137 Headache, 73, 126, 137, 148 Headache Disorders, 137 Health Promotion, 82, 137 Health Status, 134, 138 Heartburn, 64, 65, 66, 69, 71, 73, 74, 75, 76, 77, 78, 138, 140 Hemoglobin, 73, 122, 125, 133, 138 Hemoglobinuria, 100, 138 Hemorrhage, 130, 137, 138 Hemorrhoids, 65, 66, 73, 76, 77, 78, 138 Hepatic, 122, 135, 138 Hepatitis, 75, 138 Hepatocytes, 138 Hereditary, 5, 34, 138, 150 Heredity, 136, 138 Hernia, 76, 138 Hiatal Hernia, 64, 65, 138 Histamine, 138, 142 Homeopathic remedies, 64, 138 Hormonal, 8, 124, 129, 138 Hormone, 58, 59, 129, 136, 138, 140, 149, 151 Host, 81, 138, 151, 156 Hybrid, 138, 151 Hydrogen, 4, 5, 7, 16, 18, 28, 30, 37, 52, 73, 82, 104, 105, 124, 126, 130, 138, 139, 143, 147, 149 Hydrogen Breath Test, 7, 30, 37, 104, 105, 139 Hydrolysis, 59, 123, 124, 127, 139 Hyperbilirubinemia, 139, 141 Hypertension, 9, 82, 137, 139, 155 Hypoglycemia, 70, 80, 135, 139 I Iatrogenic, 4, 139 Ice Cream, 105, 106, 107, 139 Id, 48, 54, 108, 114, 116, 139 Idiopathic, 26, 139 Ileal, 79, 139 Ileostomy, 66, 139 Ileum, 126, 139 Ileus, 77, 139 Imaging procedures, 139, 155 Immune system, 74, 124, 138, 139, 156 Immunodeficiency, 100, 139 Immunodiffusion, 139 Immunoelectrophoresis, 69, 139

Index 161

Immunoglobulins, 73, 139, 147 Immunologic, 82, 139 Impairment, 123, 139, 140 Incision, 140, 141 Incompetence, 136, 140 Incontinence, 64, 140 Indicative, 66, 140, 146, 156 Indigestion, 64, 66, 73, 74, 75, 140, 141 Infancy, 8, 27, 43, 140 Infant, Newborn, 121, 140 Infantile, 11, 19, 140 Infarction, 129, 140, 143 Infection, 79, 123, 135, 136, 139, 140, 142, 153, 155, 156 Infectious Diarrhea, 42, 54, 140 Infertility, 77, 140 Inflammation, 69, 70, 73, 122, 123, 127, 128, 130, 131, 132, 133, 134, 136, 138, 140, 146, 148, 153, 155, 156 Inflammatory bowel disease, 38, 50, 69, 70, 73, 75, 76, 79, 140 Ingestion, 4, 8, 12, 18, 19, 43, 60, 107, 135, 140, 148 Inguinal, 77, 140 Inhalation, 140, 148 Insomnia, 140, 148 Insulin, 37, 70, 140 Insulin-dependent diabetes mellitus, 140 Intestinal Obstruction, 76, 140 Intestinal Pseudo-Obstruction, 66, 141 Intestine, 70, 76, 77, 82, 88, 106, 125, 126, 128, 132, 141, 149, 150, 152 Intoxication, 141, 156 Intracellular, 126, 140, 141, 148 Invasive, 4, 69, 141 Involuntary, 124, 133, 134, 141, 144 Ions, 124, 132, 139, 141 Irritable Bowel Syndrome, 4, 20, 21, 26, 41, 64, 65, 66, 71, 72, 75, 76, 77, 79, 87, 88, 135, 141 Ischemia, 124, 141 J Jaundice, 75, 139, 141 Jejunostomy, 132, 141 K Kb, 96, 141 Kidney Disease, 71, 96, 101, 104, 108, 141 L Large Intestine, 141 Latent, 6, 141, 148 Laxative, 141, 152 Lens, 126, 141

Lesion, 141, 155 Leukemia, 100, 142 Library Services, 114, 142 Ligament, 142, 149 Linkages, 138, 142, 146 Lipid, 140, 142 Liver, 65, 71, 72, 75, 77, 79, 121, 122, 124, 131, 134, 135, 138, 142, 151, 155 Localized, 121, 140, 142, 147, 155, 156 Loop, 138, 139, 142 Loperamide, 37, 142 Lower Esophageal Sphincter, 136, 142 Lupus, 64, 142 Lymph, 142, 148 Lymphatic, 140, 142, 153 Lymphatic system, 142, 153 Lymphoid, 123, 142 Lymphoma, 29, 100, 142 M Malabsorption, 4, 6, 7, 14, 28, 35, 39, 55, 60, 69, 75, 76, 77, 83, 100, 126, 142, 152 Malabsorption syndrome, 142, 152 Malignant, 100, 142 Malnutrition, 5, 22, 73, 75, 79, 122, 124, 142, 144 Meat, 131, 142, 143 Meat Products, 131, 143 MEDLINE, 97, 99, 101, 143 Megacolon, 71, 143 Megaloblastic, 134, 143 Melanocytes, 143 Melanoma, 100, 143 Membrane, 128, 143, 144, 145, 147, 148 Memory, 122, 143 Meninges, 127, 130, 143 Menopause, 143, 146, 148 Menstrual Cycle, 143, 148, 149 Menstruation, 122, 143, 148 Mental Health, iv, 9, 63, 96, 98, 143, 145 Metabolite, 60, 131, 143 MI, 6, 8, 65, 69, 73, 87, 88, 106, 119, 143 Microbiology, 121, 143 Microorganism, 58, 128, 143 Milliliter, 125, 143 Modification, 10, 82, 143 Molecular, 58, 97, 99, 125, 129, 143 Molecule, 123, 124, 128, 139, 143, 150 Morphology, 21, 40, 143 Motility, 68, 135, 144, 152 Motion Sickness, 144 Mucins, 132, 137, 144 Mucosa, 6, 73, 127, 132, 136, 142, 144

162 Lactose Intolerance

Mucus, 144, 155 Muscle Fibers, 144 Muscular Atrophy, 100, 144 Muscular Dystrophies, 132, 144 Myocardium, 143, 144 Myotonic Dystrophy, 100, 144 N Nasogastric, 132, 144 Nausea, 5, 7, 64, 73, 74, 78, 80, 88, 105, 106, 118, 130, 136, 140, 144, 145, 148, 155 Necrosis, 140, 143, 144 Need, 3, 10, 63, 64, 68, 69, 71, 72, 76, 81, 87, 88, 109, 127, 144, 154 Neoplasia, 100, 144 Neoplastic, 142, 144 Nephropathy, 141, 144 Nerve, 121, 123, 135, 136, 144, 151 Nervous System, 100, 127, 144, 154 Neuroleptic, 144, 145 Neuromuscular, 22, 121, 144, 155 Nitrogen, 121, 144, 145 Nucleus, 124, 130, 145, 149, 154 Nutritional Status, 51, 68, 145 Nutritional Support, 68, 73, 136, 145 Nutritive Value, 135, 145 O Occupational Medicine, 33, 145 Oncogene, 100, 145 Ondansetron, 71, 145 Opacity, 126, 130, 145 Osmosis, 145 Osmotic, 59, 122, 145 Osteoporosis, 9, 10, 22, 33, 37, 76, 77, 88, 104, 145 Ovaries, 133, 145, 152 Oxygen Consumption, 145, 150 P Palliative, 12, 145, 154 Pancreas, 75, 77, 79, 121, 131, 140, 145, 146, 151 Pancreatic, 64, 69, 72, 75, 100, 136, 145, 146 Pancreatic cancer, 64, 75, 100, 145 Pancreatic Insufficiency, 69, 145 Pancreatic Juice, 136, 146 Pancreatitis, 75, 146 Paneth Cells, 132, 146 Parasite, 146, 155 Paroxysmal, 100, 137, 146 Partial remission, 146, 150 Pathologic, 4, 73, 125, 129, 139, 146 Pathophysiology, 79, 146 Patient Education, 105, 112, 114, 119, 146

Pediatrics, 12, 13, 17, 19, 21, 23, 32, 36, 38, 40, 43, 46, 49, 52, 54, 68, 146 Pelvic, 146, 149 Pepsin, 146, 151 Pepsin A, 146 Peptic, 5, 72, 78, 146 Peptic Ulcer, 72, 78, 146 Peptide, 146, 149 Perimenopausal, 17, 20, 146 Peritoneum, 146 Peritonitis, 76, 78, 146 Pernicious, 77, 78, 143, 146 Pernicious anemia, 77, 78, 146 PH, 125, 147 Pharmaceutic Aids, 135, 147 Pharmacologic, 147, 155 Pharynx, 136, 147 Phenylalanine, 123, 146, 147 Phospholipids, 134, 147 Phosphorus, 126, 147 Physical Examination, 69, 147 Physiologic, 9, 73, 125, 143, 147, 150 Physiology, 5, 46, 50, 80, 147 Pigment, 124, 143, 147 Placebo Effect, 19, 147 Plants, 123, 126, 137, 143, 147, 151, 155 Plasma, 18, 37, 122, 123, 137, 138, 147, 151 Plasma protein, 122, 147 Pleura, 148 Pleurisy, 72, 148 Poisoning, 64, 133, 135, 136, 141, 144, 148 Policy Making, 137, 148 Polycystic, 101, 148 Polyposis, 128, 148 Posterior, 122, 123, 145, 148 Postmenopausal, 21, 145, 148 Postprandial, 71, 148 Potassium, 148 Practice Guidelines, 98, 148 Precursor, 133, 147, 148 Predisposition, 6, 148 Premenstrual, 71, 148 Premenstrual Syndrome, 71, 148 Prevalence, 4, 6, 9, 38, 39, 41, 42, 47, 68, 79, 148 Proctosigmoiditis, 79, 149 Progesterone, 149, 153 Progressive, 127, 131, 137, 144, 149 Prostate, 100, 149 Protein C, 122, 149, 155 Protein S, 67, 101, 125, 149 Protein-Energy Malnutrition, 26, 28, 149

Index 163

Proteins, 73, 122, 123, 128, 139, 143, 145, 146, 147, 149, 152, 155 Protocol, 60, 149 Protons, 139, 149 Protozoa, 143, 149 Proximal, 131, 149 Pruritic, 132, 149 Puberty, 10, 149 Public Policy, 97, 149 Pulmonary, 125, 129, 149 Pulmonary Artery, 125, 149 Putrefaction, 58, 149 Pylorus, 131, 149 Q Quackery, 74, 149 R Radioactive, 139, 150 Radioisotope, 150, 155 Radiology, 42, 150 Randomized, 6, 11, 132, 150 Receptor, 121, 123, 145, 150, 152 Rectal, 76, 107, 150 Rectum, 75, 76, 123, 125, 128, 131, 134, 136, 140, 141, 149, 150, 152 Red blood cells, 73, 133, 150, 151 Red Nucleus, 124, 150 Refer, 1, 125, 128, 135, 144, 150 Reflux, 136, 150 Refractory, 4, 150 Regimen, 132, 147, 150 Regurgitation, 136, 138, 150 Remission, 8, 73, 150 Resection, 23, 36, 79, 150, 152 Respiration, 79, 126, 150 Resuscitation, 132, 150 Retinoblastoma, 100, 150 Retinoids, 150, 156 Risk factor, 10, 33, 51, 65, 107, 150 Rye, 69, 76, 77, 127, 133, 151 S Saccharin, 74, 151 Salivary, 131, 145, 151 Salivary glands, 131, 151 Saponins, 151, 153 Schizoid, 151, 156 Schizophrenia, 151, 156 Schizotypal Personality Disorder, 151, 156 Sclerosis, 100, 151 Screening, 128, 151 Seafood, 74, 151 Secretin, 58, 59, 151 Secretion, 129, 138, 140, 144, 145, 151

Seizures, 146, 151 Semen, 149, 151 Senile, 145, 151 Sensor, 18, 151 Serotonin, 145, 151 Serum, 77, 122, 128, 146, 148, 152 Sex Characteristics, 121, 149, 152 Sex Determination, 101, 152 Short Bowel Syndrome, 66, 69, 152 Side effect, 64, 73, 91, 121, 152, 155 Sigmoid, 149, 152 Sigmoid Colon, 149, 152 Signs and Symptoms, 65, 69, 79, 107, 150, 152, 155 Skeletal, 10, 144, 152 Skeleton, 13, 152 Small intestine, 5, 59, 60, 69, 70, 76, 77, 107, 124, 126, 131, 132, 138, 139, 141, 144, 152, 156 Smooth muscle, 126, 138, 152, 154 Sodium, 152, 154 Soft tissue, 152 Solvent, 133, 145, 152 Sorbitol, 72, 152 Spasmodic, 121, 152 Spastic, 141, 152 Specialist, 77, 109, 153 Species, 126, 136, 138, 146, 153, 155 Sphincter, 80, 153 Spinal cord, 127, 143, 144, 153 Spleen, 72, 142, 153 Sporadic, 150, 153 Sprue, 63, 153 Statistically significant, 6, 153 Steatorrhea, 80, 153 Sterility, 140, 153 Steroid, 10, 73, 129, 151, 153 Steroid therapy, 73, 153 Stimulant, 126, 138, 153 Stomach Ulcer, 64, 153 Stool, 69, 71, 77, 105, 106, 140, 141, 153 Stool test, 77, 106, 153 Stress, 72, 79, 129, 135, 136, 141, 144, 148, 153, 156 Subacute, 140, 153 Subarachnoid, 137, 153 Subclinical, 140, 151, 153 Substance P, 143, 151, 154 Substrate, 58, 154 Supplementation, 5, 154 Support group, 66, 154 Sweat, 69, 154

164 Lactose Intolerance

Sweat Glands, 154 Symphysis, 149, 154 Symptomatic, 4, 5, 43, 47, 74, 146, 154 Systemic, 73, 92, 123, 125, 140, 154 Systolic, 139, 154 T Telangiectasia, 101, 154 Thalamic, 123, 154 Thalamic Diseases, 123, 154 Therapeutics, 41, 50, 92, 154 Thorax, 121, 154 Threshold, 139, 154 Thrombosis, 149, 154 Thyroxine, 122, 147, 154 Tolerance, 4, 5, 6, 7, 9, 19, 21, 40, 42, 43, 53, 60, 69, 82, 83, 89, 118, 137, 154 Tomography, 125, 154 Tooth Preparation, 121, 154 Toxic, iv, 71, 127, 132, 137, 151, 155 Toxicity, 131, 155 Toxicology, 98, 155 Toxins, 123, 140, 155 Tracer, 61, 155 Transfection, 125, 155 Trauma, 133, 144, 146, 155 Trichomoniasis, 64, 155 Tuberculosis, 129, 142, 155 Tuberous Sclerosis, 101, 155 U Ulcer, 42, 146, 153, 155 Ulceration, 70, 155

Ulcerative colitis, 26, 27, 65, 66, 69, 70, 72, 76, 78, 79, 140, 155 Unconscious, 139, 155 Uraemia, 146, 155 Urea, 154, 155 Urethra, 149, 155 Urinary, 71, 140, 155 Urine, 125, 131, 138, 140, 155 Urticaria, 17, 155 Uterus, 132, 143, 145, 149, 156 V Vaccine, 149, 156 Varices, 77, 156 Vascular, 137, 140, 155, 156 Vasculitis, 146, 156 Veins, 125, 156 Venous, 125, 138, 149, 156 Vertebral, 33, 156 Veterinary Medicine, 97, 156 Villi, 21, 156 Villous, 127, 156 Viruses, 74, 140, 143, 156 Viscosity, 17, 156 Vitamin A, 80, 156 W Weight Gain, 5, 64, 134, 156 Weight-Bearing, 23, 156 White blood cell, 123, 142, 144, 156 Withdrawal, 82, 156 Wound Healing, 79, 156 X X-ray, 125, 150, 156

Index 165

166 Lactose Intolerance

Index 167

168 Lactose Intolerance