Polly,
Excellent point. Obviously, Dr. Fine was not only correct, but he was way ahead of the pack, (which is not surprising, since he seems to have been, (and still is), light years ahead of the pack, in diagnosing and treating MC, celiac disease, and gluten sensitivity in general. Here is an abstract of an article recently published in the American Journal of Gastroenterology, (September, 2008), showing evidence of an association between the use of oral contraceptive agents, and the risk of development of an IBD:
http://www.citeulike.org/user/Zephyrus/article/3179846
To confuse the issue, here is an article showing how HRT can be protective of IBD flares, in post-menopausal women:
http://www.nature.com/ajg/journal/v103/ ... 8239a.html
However, I don't see any mention in this abstract, of the form of HRT used in this trial. Obviously, if transdermal patches were used to administer the HRT, that would preclude the direct effects on the GI tract, caused by oral treatment.
Like you, my guess is that the oral treatment was the problem, rather than the lactose. Here's why I feel that way: Pharmaceutical lactose is pure, which should preempt the possibility that it might contain any casein. While it is true that we are "intolerant" of lactose, anytime that we have any enteritis originating in the small intestine or upstream of there, this is not the same type of intolerance as that caused by proteins. Instead, it is merely due to the incomplete digestion of lactose, because of a shortage of the lactase enzyme, which results in the undigested lactose passing into the colon, where it ferments, resulting in gas and bloating, (but not an autoimmune reaction, so no inflammation should be produced).
It is true, however, that this type of reaction can include diarrhea, so it is certainly possible that this was causing your problem, though typically, such small amounts shouldn't result in mal-digestion of lactose, since lactase production is usually just reduced, not stopped completely. A good clue to consider, in this case, would be whether or not any of the other typical MC symptoms were present, in addition to the D, (such as aches, pains, joint pains, stiffness, brain fog, etc.). The swollen fingers, for example, would suggest more than just a simple case of lactose intolerance. At least, that's my take on the situation.
Lyn wrote:I think there is a lesson in here. If we are doing well we may not have problems with small amounts of irritants, but keep doing it and they'll get you every time.
Truer words were never spoken. Gluten, especially, has a cumulative effect, and our bodies might ignore a small amount, (as long as it is below our threshold for a reaction), but our GI tract is like a production line, and if we continue to add small amounts of intolerants, on a regular basis, eventually, the accumulated amount that's in the system, at any given time, will be more than it can handle, and our immune system will begin to produce antibodies, and when they become numerous enough, we will find ourselves in a flare.
Good detective work, Lyn. Thanks for posting that information. I hope you have clear sailing from here on.
Tex
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