Could bowel troubles after dairy mean irritable bowel syndrome?
Ask the expert
Q. Every time I eat dairy, I get diarrhea and have to run to the bathroom almost the whole day. But when I use products such as Lactaid, I get constipated. What is wrong here? Are there vitamins I need to take to obtain a healthy and normal bowel movement?
A. Your symptoms are very suggestive of irritable bowel syndrome (IBS). This condition is extremely common, and diarrhea alternating with constipation is a classic symptom. The other common symptoms are abdominal pain and bloating.
There is no specific diagnostic test that can confirm whether or not a person has IBS. It is what doctors call a clinical diagnosis. Diagnosing IBS is not so easy because its symptoms vary considerably from one person to the next. Many people with IBS have just diarrhea and others have just constipation. Not everyone alternates between the two.
In general, people with IBS have at least three months of continuous or recurring symptoms of abdominal discomfort that
- May be relieved with a bowel movement
- may be coupled with a change in frequency of bowel movements
- may be related to a change in the consistency of stools.
Just as important, there should not be weight loss, fever, or rectal bleeding.
Even when a person's symptoms fit this description, experts have different opinions about how much testing needs to be done to make sure that there is not some other diagnosis.
You should discuss your symptoms with your doctor. You may have both IBS and lactose intolerance. Both are common. In addition, you may also discover that fructose and related carbohydrates trigger your symptoms. Dietary sources of fructose include fruits, honey, and high-fructose corn syrup.
Regarding your question about vitamins or other nutritional supplements, they are not likely to help. But this does raise an important point. Celiac disease is one of the diagnoses to consider in someone with persistent or recurrent diarrhea. It is quite common, especially in people of European ancestry. It can cause poor absorption of certain vitamins and minerals.
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About the Author
Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
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