In a research paper on Lactose and its intolerance by Dr J Kocian at  Chair of internal medicine , P G Medical Institute , Prague, Czechoslovakia is given below along with another important study by S Kudlacek, O Freudenthaler, H Weissbeck, and B Schneider of KH Barmherzige Bruder, Medizinische Abteilung, G Mohrengasse  Vienna, Austria Ludwig Boltzmann Institute fur Altersforschung, Vienna, Austria Institut fur Medizinische Statistik, University of Vienna, Vienna, Austria respectively which deals with how lactose intolerance can effect your bones especially your back bone.

INTRODUCTION:- 
This disease is caused due to faulty digestion of Lactose, which is related to glucose, and mainly caused due to faulty absorption of milk or dairy products. This is due to total or partial absence of the enzyme Lactase, which helps in the absorption of milk products.

CLASSIFICATION:-
Lactose intolerance is classified as:
1. Genetic
2. Acquired, ie, after inflammation of mucosa
3. Transitory- due to diseases in the intestinal mucosa, which heals later on.

DIAGNOSIS:- 
If the patients complain of fullness, bloating, rumbling, flatulence, pain and diarrhea in the stomach, then there are good chances that the patient is suffering from Lactose Intolerance (LI) Since lactose is not split into glucose and galactose and is not absorbed in the intestine, the amount of water increases causing pressure on the walls of the intestines and hence causing these symptoms. In case of partial lactose intolerance, bloating may occur, whereas in severe cases, diarrhea may occur.

METHODS:-
Laboratory: -
1. A Lactose tolerance test can be done to confirm diagnosis.
2. X- Ray: - After taking a barium meal with Lactose, the absorption pattern can be studied.
3. Histochemistry: - Intestinal mucosa specimen is studied under microscope and evaluated.
4. Isotope method: - Examination of Co2 in breath by giving the patients lactose with chemicals.

RELATIONSHIP OF LACTOSE INTOLERANCE AND GASTROINTESTINAL DISEASES:-
Can be divided into four groups:-
1. Lactose Intolerance (LI) can also cause gastric complaints and should be separated from other gastric diseases.
2. LI can cause worsening of some stomach diseases like Crohn's disease.
3. LI can develop, due to other infections of the intestines.
4. LI can be hidden under other diseases of the stomach.

TREATMENT:-
Specific treatment of this disease is not known, only treatment is to reduce signs and symptoms of discomfort.
1. Dietetic Arrangement: - by giving a milk free diet, this problem can be controlled and later on titrated for maximum tolerance.
2. Delactosed milk: - There are products available without lactose, or using milk fermented with yeast and using curd.
3. By adding Lactase to milk: - By adding this enzyme, 4 to 6 hours before consumption.
4. Prevention.
5. Treatment of complications: - Diseases like Osteoporosis can be treated by giving supplements of Calcium, Vitamin D, sodium fluoride, and exercises, etc. This is further explained in the research given below.

BACKGROUND: - The purpose of this study was to find out any differences in bone density, risk of fractures and visual changes in patients with lactose intolerance.
It was concluded that patients with lactose intolerance appear not to be at risk for bone density loss.

INTRODUCTION:-
Osteoporosis can occur due to various reasons. Apart from hormonal problems, Calcium intake in diet is a major risk factor for bone loss. In lactose intolerance, since milk or milk products can cause stomach problems to the patients, they themselves avoid milk, which in turn could lead to a low calcium diet. However, the relation between lactose intolerance and its effect on bone density needs to be studied to make a final statement on this.

PATIENTS AND METHODS:-
Those patients who came to the OPD for measuring bone density were selected and given a questionnaire.
Hydrogen breath test: - The patient's breath Hydrogen was measured before having lactose.
LUMBAR VERTEBRAE: - Bone density was measured using a Bone Density Meter, in the vertebra of elderly patients.
BIOCHEMISTRY: - Blood chemistry including calcium phosphate levels was measured in patients using laboratory techniques.

RESULTS:-
Around 218 subjects were screened, who had the same discomfort after taking milk, as reported in the questionnaire. It appeared from the data that vertebral fractures numbers increased in patients having lactose intolerance, as compared with healthy patients.

DISCUSSION:-
It was also noticed that there was no effect of lactose intolerance on bone density, as compared to normal patients. It was also realized from this study that flatulence, diarrhea and other symptoms did not differ between lactose intolerance patients and normal subjects, in spite of the fact that they took two cups of milk daily. However, when all types of fractures were analyzed; more vertebral fractures were found in patients with lactose intolerance; as compared to groups having irritable bowel disease only.
Hence we can conclude that lactose intolerance does not affect bone density, although we did find some increase of vertebral fractures in some patients.

Compiled from various international research journals available at google scholar by D. Mukherjee having 38 years of pharmaceutical (Cardiac, Diabetic, Neurology, Pain & Inflammation products) experience with a Swiss Multinational Company NOVARTIS and edited by Dr Sandeep Ahlawat, MBBS