Milk and cookies, coffee with cream, hot fudge sundaes -- the stuff of dreams or nightmares? If you or your child is one of the millions of Americans with lactose intolerance, read on.

Lactose intolerance is the inability to digest lactose or milk sugar due to an absence or decrease in the amount of lactase the body produces. Lactase is produced in the villi, little finger-like projections in the small intestine. Every year after age two, our bodies slowly decrease the amount of lactase produced. It might take years for lactose intolerance to show up. However, by the time they reach adulthood, most people have a significantly reduced tolerance for lactose. Some people are born with lactose intolerance, and from childhood on are not able to properly digest milk.

Symptoms of lactose intolerance include cramps, bloating, canker sores, yeast infections, diarrhea, and gas. These are because the natural bacteria living in our digestive systems eat the lactose (that has not been broken down) and excrete the gas, which causes the bloating and cramps we associate with lactose intolerance. Yeast is a fungus and lactose is a sugar. Since people with lactose intolerance can't break down and then dispose of lactose, it winds up in their bloodstream. Yeast feed on the lactose (or any other sugar) and multiplies, causing a yeast infection.

The tendency toward lactose intolerance is hereditary. You will find lactose intolerance runs in ethnic groups. Approximately 90% of the Asian and American Indians populations are lactose intolerant. That is why one will never see dairy foods in an Asian restaurant. The notable exception to this is Indian restaurants since people from India are the only Asians who are not effected this way.

Hidden lactose is in many foods. If you see any of the following on an ingredients label, the product contains lactose.

Whey is used to make spices stick to food so it pops up in foods you would never expect to be dairy, such as seasoned french fries or packaged stuffing mixes.

There is no cure for lactose intolerance and the only treatment is to stay away from foods containing lactose or to use lactase milk or take lactase supplements.

Lactase can be purchased over the counter in pill or liquid form. Lactase pills and liquid replace the enzyme missing in lactose intolerant people. People can develop a tolerance to lactase supplements, so daily use of them is not for all lactose intolerant people. You can get a free sample by calling 1-800-LACTAID, 9 AM -5PM EST. Lactase supplements also cause digestive problems in some people.

Some people who are only mildly lactose intolerant can eat live culture yogurt (some of the lactose being digested by the yogurt cultures), hard cheese or butter.

Many lactose intolerant people worry about their calcium intake. These days it is easy to get enough calcium even without dairy products since so many fruit juices are fortified with calcium. Additional sources of calcium include rice milk; soy milk; green vegetables such as broccoli, kale, bok choy (Chinese cabbage), collard greens, turnip greens and kale; and fish with edible bones, such as salmon and sardines.

Here's a great recipe for the lactose intolerant:

Sue Long has been a vegetarian for more than 10 years. Her interest in nutrition started when she was in nursing school.