Lactose Intolerance

Many people have trouble digesting the sugar in milk, called lactose. This is known as lactose intolerance. When someone with lactose intolerance eats or drinks milk or other dairy products, their bodies can't fully break down the lactose. This leads to uncomfortable symptoms like diarrhea, gas, and bloating.

Lactose intolerance happens because the body doesn't produce enough of an enzyme called lactase. Lactase is made in the small intestine and helps digest lactose. Even if you have a little bit of lactase, you might still be able to handle some dairy. But if the amount of lactase is too low, your body can't break down the lactose properly, causing those uncomfortable symptoms. This condition is usually not serious, but it can be unpleasant.

Lactose intolerance often causes problems within 30 minutes to 2 hours after eating or drinking something with lactose. This is because your body has trouble digesting the sugar called lactose in dairy products. Common reactions include:

• Loose stools (diarrhea): This is one of the most frequent symptoms. Loose stools can range from slightly watery to more severe diarrhea.
• Upset stomach (nausea): Feeling queasy or sick to your stomach is common. In some cases, nausea can lead to vomiting.
• Stomach pain (cramps): Pain in the stomach area, often described as cramping, is a typical symptom. This pain can be mild or quite intense.
• Feeling full or swollen (bloating): Your stomach might feel unusually swollen or tight after eating.
• Gas: Excessive gas buildup is another frequent reaction. This can lead to discomfort and sometimes even pain.

See your doctor if you often have problems after eating dairy products, like gas, bloating, or stomach aches. This is especially important if you're concerned about getting enough calcium in your diet. If you're experiencing these issues regularly, a doctor can help figure out what's going on and suggest the best course of action, perhaps including ways to get enough calcium from other foods.

Lactose intolerance happens when your small intestine doesn't make enough of an enzyme called lactase. Lactase is needed to break down lactose, which is the sugar found in milk and dairy products.

Normally, lactase works like a tiny chef, turning lactose into two simpler sugars: glucose and galactose. These simpler sugars are then easily absorbed into your bloodstream through the lining of your intestines.

But if you have trouble making enough lactase, the lactose in the food you eat can't be broken down and absorbed properly. Instead, it travels to your large intestine (colon). Here, bacteria that live naturally in your gut start to feed on the undigested lactose. This feeding process produces gas, bloating, cramps, and other uncomfortable symptoms.

There are different reasons why someone might not produce enough lactase, leading to three main types of lactose intolerance. These different types are caused by different factors in the body.

Several things can make you or your child more likely to have trouble digesting lactose (a sugar in milk).

• Getting older: Lactose intolerance often develops during adulthood. It's not very common in babies and young children. As we age, our bodies may produce less of the enzyme lactase, which is needed to break down lactose.

• Background: People of African, Asian, Hispanic, and American Indian descent are more likely to develop lactose intolerance. This is because there's often a genetic tendency for these groups to have lower lactase production.

• Early birth: Premature babies might have lower-than-normal levels of lactase. This is because the body's ability to produce lactase usually develops later in pregnancy, during the third trimester.

• Gut issues: Problems with the small intestine can lead to lactose intolerance. These problems include:

  • Bacterial overgrowth: Too many bacteria in the small intestine can interfere with digestion.
  • Celiac disease: A condition where the immune system attacks the lining of the small intestine.
  • Crohn's disease: A chronic inflammatory condition of the digestive tract that can affect the small intestine. These conditions can damage the parts of the intestine that produce lactase.

• Medical treatments: Certain cancer treatments can increase the risk of lactose intolerance. For example, radiation therapy to the stomach or intestinal complications from chemotherapy can sometimes harm the cells that produce lactase.

Doctors might suspect lactose intolerance based on how you feel and how your body reacts when you eat less dairy. To be sure, they'll likely do one or more tests.

Hydrogen Breath Test: This test checks how well your body breaks down lactose. Your doctor will give you a liquid with a lot of lactose. Then, they'll measure the amount of hydrogen gas in your breath at specific times. If you have too much hydrogen in your breath, it means your body isn't properly digesting the lactose. This is because when your body has trouble breaking down lactose, bacteria in your gut produce hydrogen gas as a byproduct.

Lactose Tolerance Test: This test also helps determine if your body is processing lactose correctly. You'll drink a liquid with a lot of lactose. Two hours later, your doctor will take a blood sample to check your blood sugar (glucose) levels. If your blood sugar doesn't go up much after drinking the lactose-rich liquid, it suggests your body isn't properly absorbing the lactose. This means your body isn't producing enough of the enzymes needed to digest lactose. A normal response would show a rise in blood sugar as the body digests the lactose and converts it to glucose.

People with lactose intolerance sometimes have an underlying medical issue. Treating this underlying problem might help their bodies digest lactose again, but this can take several months. For other cases of lactose intolerance, a low-lactose diet can help avoid the unpleasant symptoms.

To reduce lactose in your diet:

• Cut back on milk and other dairy products: This means less cheese, yogurt, and other dairy foods. Gradually reducing your intake is often easier than doing it all at once.
• Incorporate dairy in moderation: Don't completely eliminate dairy. Instead, include small amounts of dairy in your regular meals. A small portion of cheese on a sandwich or a tiny bit of yogurt with fruit can be part of a healthy diet.
• Choose lactose-reduced options: Look for lactose-reduced milk and ice cream. These options are readily available and can help you enjoy dairy products without the discomfort.
• Use lactase enzyme: You can add lactase enzyme to milk or dairy products. This enzyme helps break down lactose, making it easier to digest. This is available in liquid or powder form. You can often find this in grocery stores.