If your stomach gurgles and rumbles every time you have a glass of milk, you must be wondering about lactose intolerance. The condition is, after all, quite common, with an estimated 30 million adults in the United States having lactose intolerance by the age of 20.1 If you suspect you fall into this category, here’s a roundup of everything you need to know. And if you do turn out to be lactose intolerant, don’t worry yet – treating the problem doesn’t always mean cutting out all dairy foods from your life.
What Is Lactose Intolerance?
Lactose intolerance is a digestive problem that occurs when your small intestine does not produce adequate amounts of the enzyme lactase needed to digest lactose. The lactase deficiency and lactose malabsorption develop into lactose intolerance and the trademark digestive system symptoms detailed later.
Lactose Intolerance Versus Dairy Allergy
Lactose tolerance is not an allergy to dairy products: Yes, lactose is found in dairy products like milk, yogurt, and cheese and is a kind of sugar. But, remember, intolerance is not the same as a dairy allergy, where your immune system reacts adversely to the proteins in these foods.
The immune system is not involved in lactose intolerance. In fact, people with lactose intolerance may actually be able to have some amount of lactose without much problem, depending on how severe their level of intolerance is.2 Yogurt, butter, and cream typically present less of a problem. Some people can even tolerate small amounts of milk.3
Symptoms of dairy allergy versus lactose intolerance: When you have a dairy allergy, you are likely to see itching, vomiting, hives, wheezing, repetitive coughing, shortness of breath, or, in really bad cases, anaphylactic shock – all signs of allergic reactions. Not unlike what you’d experience when you consume any food you’re allergic to, like nuts for instance.4 Lactose intolerance, on the other hand, is marked by digestive symptoms such as abdominal pain, bloating, and the like.5
Causes Of Lactose Intolerance
So what causes lactose intolerance? Is it something you’re born with or is it something you develop later in life? As it turns out, the reasons for the problem are varied. While some are born with the problem, others develop it in the aftermath of illness or surgery. Even your genes and heritage could play a part.6
1. Premature Birth
Babies who make it to full term don’t normally develop lactose intolerance in infancy. However, babies who are preterm at birth could have lactose intolerance. Full-term babies usually don’t reveal any symptoms of lactose intolerance before age 3.
2. Genetic Defects
Some babies are simply born without the gene needed for the body to produce lactase, making them lactose intolerant.
3. Infections And Illness
When you undergo treatment for certain problems like an infection of the small intestine or have a disease that can damage it like Crohn’s disease or celiac sprue, you could end up developing lactose intolerance. Sometimes surgery of the small intestine too might set off lactose intolerance.
4. Heritage And Roots
Lactose intolerance may show up in childhood with certain races and ethnicities more predisposed to this problem. According to the National Institutes of Health, it is more common among adults who have African, Asian, and Native American roots and less likely to occur in those of Western European or Northern European heritage.7
Symptoms: Signs That You Could Be Lactose Intolerant
There are some typical signs of lactose intolerance that you should be able to spot easily.8 As mentioned earlier, these are usually digestive symptoms and occur after you’ve had milk or milk products. These include:9
- Flatulence or wind
- Stomach cramps and pain
- A rumbling in your stomach after having lactose
- Bloating or swelling of the stomach
- Feeling sick or nauseous
- A feeling of fullness in the belly
Symptoms Of Lactose Intolerance In Babies
Babies that are lactose intolerant and are having breast milk or formula may have some of these symptoms10:
- Swollen stomach
- Inability to settle down at feeding time
- Diarrhea or frothy/watery or bulky feces
- Failure to put on weight
- Pain in the stomach
- Sore red bottom. The skin may even look worn away in spots
Tests To Detect Lactose Intolerance
A doctor will typically take your medical and family history and understand your diet as well as symptoms you have experienced. They will then conduct a physical exam to check for abdominal bloating, tenderness, pain, and listen for sounds in the abdomen using a stethoscope. Medical tests like a hydrogen breath test or a stool acidity test to check for undigested lactose may also be prescribed.11
Treatment For Lactose Intolerance: What Are Your Options?
Once diagnosed, you can tackle your lactose intolerance by following some broad steps toward treatment. Remember, there is no known cure for lactose intolerance, but there are ways to manage it better.
1. Cut Down Lactose Intake
Your doctor will suggest you cut back on lactose intake to ease symptoms. You may then slowly introduce small quantities of different foods with lactose to gauge your tolerance levels. If avoiding lactose-containing food and drink doesn’t help your condition, it may be something else. For instance, you may have Irritable Bowel Syndrome (IBS) that can result in similar problems.12
2. Stagger Lactose Intake
If you do have lactose in your diet, ensure it is spread across different meals and is consumed in small amounts along with other foods that your body is not sensitive to.13
3. Add Lactase To Help Digest Lactose
A small amount of lactase enzymes can also be added to the regular milk you have been drinking to help your body digest the lactose. You can take them as tablets or drops along with meals as well.14 Consult a doctor to be sure.
4. Take Vitamin And Mineral Supplements
If you have cut down on dairy intake significantly, you may need supplements. Your doctor may suggest having Vitamin D and calcium supplements to ensure your body gets enough of the nutrients for things like keeping up bone health.15
5. Consult With A Dietician
You may need nutritional advice from a professional and your doctor may direct you to a good dietician. You could also seek out this help on your own so that a suitable diet plan that factors in your lactose intolerance can be worked out.16
6. Watch Out For Hidden Lactose
Some processed foods can carry lactose too. Even medication can use it as a filler. Here are some foods that could carry hidden lactose.
- Potato Chips
- Pancake/Cake/Waffle Mixes
- Processed meats (sausage/bacon/cold cuts)
- Salad dressings
- Instant coffee/Instant soup
Your best bet is to read the label and check for ingredients. Buying products labeled “Vegan” is another alternative. For medication, inform your doctor that you’re lactose intolerant so they can check that the medication is lactose-free.
Why You Should Avoid Low-Fat And Non-Fat Milk
Low-fat and non-fat milk are actually worse for you if you are lactose intolerant because they might move too quickly through the gut, compounding the problem.17
So How Much Lactose Can You Have?
Some people are able to drink 240 ml of milk a day, but this number is something you will need to work out for your individual condition based on your own tolerance.18
|↑1, ↑6, ↑7||Lactose intolerance. US National Library of Medicine.|
|↑2, ↑9, ↑11||Lactose Intolerance.The National Institute of Diabetes and Digestive and Kidney Diseases.|
|↑3, ↑13, ↑17, ↑18||Lactose intolerance. Department of Health & Human Services, State Government of Victoria, Australia.|
|↑4||Food Allergy. American College of Allergy, Asthma & Immunology.|
|↑5||Heyman, Melvin B. “Lactose intolerance in infants, children, and adolescents.” Pediatrics 118, no. 3 (2006): 1279-1286|
|↑10||Lactose intolerance in babies. Department of Health Western Australia.|
|↑12, ↑14, ↑15, ↑16||Lactose intolerance. NHS.|