What is Lactose Intolerance?

​Lactose intolerance is when your body cannot break down or digest lactose, some sugar in milk, and milk products.  It occurs when the small intestine does not produce enough of a digestive enzyme, called lactase, that breaks down the lactose in food so that the body may absorb it.  People who are lactose intolerant can have unpleasant symptoms after consuming milk or milk products.  These symptoms can include bloating, diarrhea, and gas.

What is Lactose Intolerance?
By Pierre Mouchette | Bits-n-Pieces

Lactose intolerance is when your body cannot break down or digest lactose, some sugar in milk and milk products.  It occurs when the small intestine does not produce enough of a digestive enzyme, called lactase, that breaks down the lactose in food so that the body may absorb it.  People who are lactose intolerant can have unpleasant symptoms after consuming milk or milk products.  These symptoms can include bloating, diarrhea, and gas.
 
What causes lactose intolerance?
Children and adults alike can have lactose intolerance.  The following are some common causes of this condition:

• Lactose intolerance often runs in families (hereditary). 
• Over time, the body can make less of the lactase enzyme. 
• Sometimes, the small intestine will stop making lactase after an injury, disease, or infection. 
• A few premature babies may not be able to make enough lactase.  Usually, a short-term problem that goes away.
• In some cases, people are born without the ability to produce lactase.

 
What are the symptoms of lactose intolerance?
Each person’s symptoms may vary.  Symptoms start about 30 minutes to 2 hours after having food or drinks that have lactose.  These symptoms may include:

• Stomach (abdominal) cramps and pain
• Nausea
• Bloating
• Gas
• Diarrhea

How severe the symptoms depend on how much lactose you have ingested and the amount of lactase your body produces. 
 
How is lactose intolerance diagnosed?
Your healthcare provider will discuss your past health and family history.  They will also provide you with a physical exam.  You may also be asked not to have milk or milk products to see if your symptoms improve.
Some tests that can help your doctor check for lactose intolerance can include:

• Lactose tolerance test: This test checks how your digestive system absorbs lactose.  You will be asked not to eat or drink for about 8 hours before the test.  You will drink a liquid containing lactose for the test, and blood samples will be taken over two hours to check your blood sugar (blood glucose) level.  You may be lactose intolerant if your blood sugar levels do not rise.
• Hydrogen breath test:  You are going to drink a liquid containing a large dosage of lactose.  Then your breath will be tested several times, where high levels of hydrogen may mean you are lactose intolerant.
• Stool acidity test:  This test is frequently used for infants and young children.  It checks how much acid is in the stool.  If someone is not digesting lactose, their stool will contain lactic acid, glucose, and other fatty acids. 

 
What About IBS?
Though lactose intolerance and irritable bowel syndrome (IBS) are two different conditions, both may cause similar symptoms in people who drink or eat milk products.
 
How is lactose intolerance treated?
No treatment can help your body make additional lactase.  But you can manage symptoms by changing your diet.  Previously, those lactose intolerants were told to avoid all milk products.  Presently, health experts suggest you try different dairy foods to see which cause fewer symptoms.  In doing this, you can still get enough calcium and other essential nutrients.  Lactose intolerance symptoms are unpleasant, but they will not hurt you.  So try to find dairy foods that do not cause severe symptoms.
The following are tips for how managing lactose in your diet:

• Start slowly: Add a small quantity of milk or milk products to see how the body reacts.
• Eat milk and milk products with other foods:  You might have fewer symptoms if you take milk or milk products with your meals.  Try eating cheese with crackers or having milk with cereal.  
• Eat dairy products with naturally lower lactose levels: hard cheeses and yogurt.
• Look for lactose-free and lactose-reduced milk and milk products: They are found at many food stores and are identical to regular milk and milk products but have the lactase enzyme added.
• Ask about lactase products:  Check with your doctor if you can take a lactase pill or drops when you eat and drink milk products.

Talk with your healthcare provider if you have difficulty finding dairy products that do not cause symptoms.  They can suggest other foods to ensure you get enough calcium, or you may need to take calcium supplements.
Note:  A healthcare provider should see children with lactose intolerance.  Children and teenagers need dairy foods.  They are a significant source of calcium for bone growth and other nutrients essential for children's health and development.
 
Live with lactose intolerance
Lactose intolerance may affect you whenever you eat a snack or meal.  So it would help to be careful about the foods you eat.  However, many people may tolerate a certain amount of lactose and do not need to avoid it altogether.
It would be best if you read all food labels.  Lactose is often added to boxed, canned, frozen, and prepared foods like:

• Bread
• Cereal
• Lunch meats
• Salad dressings
• Cake and cookie mixes
• Coffee creamers

Check food labels for words that may indicate the product has lactose, such as:

• Butter
• Cheese
• Cream
• Dried milk
• Milk solids
• Powdered milk
• Whey

 
When should I call my healthcare provider?
Call your healthcare provider if you have difficulty managing symptoms.  Some symptoms can be embarrassing.  Your healthcare provider can work with you to help keep them under control.