Elsie was 52 years old when her belly started bloating, accompanied by bursts of intermittent abdominal pain and bouts of nausea and diarrhea. As a nurse, she knew enough about her body to feel convinced that her symptoms were related to eating dairy. She had gotten the flu, and knowing that the bowel lining can sometimes lose its ability to process lactose after a gastrointestinal illness, Elsie experimented with going dairy-free. Voila! She felt better, which reassured her of her self-diagnosis of lactose intolerance. When she snuck an ice cream cone at the beach and the symptoms recurred, she felt relieved, knowing that she wasn’t suffering from anything more serious.
Then a few months passed, during which Elsie lost the job she had held at a nursing home for twenty-two years. She also lost her beloved cat and found out her husband was having an affair. In the wake of these losses and traumas, Elsie’s symptoms worsened, even though she wasn’t eating dairy, so she made an appointment with her primary care doctor.
Elsie was naked except for a skimpy paper robe when her doctor knocked briefly on the door before entering the exam room. Dr. Morrison read from the notes his medical assistant had written. “Belly pain. Bloating. Nausea. Diarrhea. Worse with dairy.”
Elsie nodded her head.
