Lactose Intolerance: Symptoms, Causes, Treatment

What are the symptoms of lactose intolerance?

Lactose intolerance occurs when the body cannot properly digest lactose, a sugar found in milk and dairy products. Symptoms typically arise after consuming dairy and can vary in severity depending on the amount of lactose consumed and the individual’s level of lactase deficiency. Common symptoms include:

1. Abdominal Pain and Cramps: Pain in the lower abdomen is a common symptom.
2. Bloating: Excess gas produced by the fermentation of undigested lactose can cause bloating.
3. Diarrhea: The presence of undigested lactose in the colon draws water into the bowel, leading to diarrhea.
4. Gas: Fermentation of undigested lactose by bacteria in the colon produces gas, leading to flatulence.
5. Nausea: Some people may feel nauseous after consuming lactose-containing foods.
6. Stomach “Growling” or Rumbling: Increased activity in the intestines can cause audible sounds.

These symptoms usually occur within a few hours after consuming lactose-containing foods or beverages. If you suspect you have lactose intolerance, it’s important to consult a healthcare provider for proper diagnosis and management. This might involve dietary adjustments, lactose-free products, or lactase enzyme supplements to help digest lactose.

What are the causes of lactose intolerance?

Lactose intolerance is caused by a deficiency of lactase, an enzyme produced by the cells lining the small intestine. Lactase is responsible for breaking down lactose, the sugar found in milk and dairy products, into simpler sugars (glucose and galactose) that can be easily absorbed into the bloodstream.

The primary causes of lactose intolerance include:

1. Primary Lactase Deficiency: This is the most common type of lactose intolerance and occurs when the body produces less lactase with age. Many people naturally start producing less lactase after childhood, leading to symptoms of lactose intolerance in adulthood.
2. Secondary Lactase Deficiency: This can occur due to injury or illness that affects the small intestine, such as infections (e.g., gastroenteritis), celiac disease, Crohn’s disease, or other conditions that damage the intestinal lining where lactase is produced.
3. Congenital or Developmental Lactase Deficiency: In rare cases, some individuals are born with a genetic mutation that leads to a severe deficiency of lactase from birth (congenital lactase deficiency) or shortly after birth (developmental lactase deficiency).
4. Ethnicity and Genetics: Certain ethnic groups, such as people of East Asian, African, Native American, and Hispanic descent, are more prone to lactose intolerance. This is often due to genetic factors that predispose individuals to produce less lactase as they age.

Understanding the underlying cause of lactose intolerance can help in managing symptoms effectively through dietary adjustments and, in some cases, lactase enzyme supplementation. If you suspect you have lactose intolerance, consulting with a healthcare provider can help confirm the diagnosis and provide guidance on managing your diet.

How is the diagnosis of lactose intolerance made?

The diagnosis of lactose intolerance is typically based on a combination of symptoms, medical history, and diagnostic tests. Here are the common methods used to diagnose lactose intolerance:

1. Symptom Assessment: Healthcare providers often start by evaluating your symptoms after consuming lactose-containing foods or beverages. Common symptoms include abdominal pain, bloating, diarrhea, gas, and nausea occurring within 30 minutes to 2 hours after ingestion.
2. Lactose Intolerance Tests:

• Lactose Tolerance Test: This involves fasting overnight followed by consuming a liquid that contains a high concentration of lactose. Blood samples are taken at intervals to measure glucose levels. In people with lactose intolerance, blood glucose levels typically rise only slightly because the body does not efficiently break down lactose into glucose and galactose.
• Hydrogen Breath Test: This test measures the amount of hydrogen in your breath after consuming a lactose solution. Normally, very little hydrogen is detectable in breath. If your body does not digest and absorb lactose normally, undigested lactose in your colon is fermented by bacteria, producing hydrogen and other gases that are absorbed into the bloodstream and exhaled through the breath. Elevated hydrogen levels indicate lactose intolerance.
• Stool Acidity Test: This test is often used for infants and young children who may not tolerate other lactose intolerance tests. It measures the acidity of stool after the child consumes lactose.

1. Elimination Diet: Sometimes, healthcare providers may recommend eliminating lactose-containing foods from your diet for a period of time to see if your symptoms improve. Reintroducing lactose-containing foods can help confirm the diagnosis if symptoms return.
2. Genetic Testing: In some cases, genetic testing may be used to identify specific genetic variations associated with lactose intolerance, especially in cases of congenital or early-onset lactase deficiency.

Diagnosing lactose intolerance involves considering your symptoms, medical history, and the results of diagnostic tests. It’s important to work with a healthcare provider to determine the most appropriate testing method for your situation and to ensure an accurate diagnosis.

What is the treatment for lactose intolerance?

Lactose intolerance is a condition where the body is unable to digest lactose, a type of sugar found in milk and other dairy products, due to a deficiency of the enzyme lactase in the small intestine. The treatment for lactose intolerance depends on the severity of the symptoms and the individual’s overall health. Here are some common treatments:

1. Dietary changes: The most common treatment for lactose intolerance is to avoid or limit foods that contain lactose. This may include:
   • Avoiding milk and dairy products like cheese, ice cream, and yogurt.
   • Reading food labels carefully to identify hidden sources of lactose, such as baked goods, processed foods, and soups.
   • Choosing lactose-free or low-lactose products, such as reduced-fat or low-fat milk, cheese, and ice cream.
2. Lactase supplements: Taking lactase enzyme supplements can help break down lactose in food and alleviate symptoms. These supplements are available in the form of pills, drops, or chewable tablets.
3. Lactase-reduced or -free products: Many food manufacturers offer lactase-reduced or -free versions of dairy products, such as milk, cheese, and ice cream.
4. Probiotics: Probiotics are live bacteria that can help restore the balance of gut bacteria and improve lactose digestion. They can be found in fermented foods like yogurt, kefir, and sauerkraut, or taken as supplements.
5. Breath testing: In some cases, a breath test may be used to diagnose lactose intolerance. This test involves blowing into a bag to collect a sample of exhaled air, which is then analyzed for hydrogen levels. If the levels are elevated, it may indicate that lactose is not being properly digested.
6. Hydrolyzed formula: In severe cases of lactose intolerance, a hydrolyzed formula may be recommended. This type of formula has already been broken down into smaller sugars that are easier to digest.

It’s important to note that lactose intolerance is different from a milk allergy, which is an immune system reaction to one of the proteins in milk (casein or whey). If you suspect you have a milk allergy or intolerance, it’s best to consult with a healthcare professional for proper diagnosis and treatment.

Remember that it’s always a good idea to consult with a healthcare professional before making any significant changes to your diet or supplement routine.