Lactose Intolerance

February 2, 2017

Lactose is the carbohydrate naturally found in all kinds of milk, including human milk. It can also be used as an ingredient in some foods. Lactose intolerance is the inability to digest the main sugar found in milk and other dairy products. This is caused by a deficiency of lactase, the enzyme responsible for metabolizing lactose in the small intestines.

To digest lactose the body contains the enzyme lactase. Lactase splits the lactose into two smaller sugars, glucose and galactose. These smaller sugars are absorbed by your body to provide energy.

When a person doesn’t have enough of the lactase enzyme to break down all of the lactose, they are said to have lactose maldigestion. The undigested lactose passes through the small intestine to the colon. In the colon, natural bacteria ferment the lactose and produce acids and gas.

This combination of events can cause the symptoms of lactose intolerance, which may include abdominal pain, bloating or diarrhoea. These warning signs of lactose intolerance can arise anywhere from 30 minutes to 2 days after the consumption of dairy products, and can range from mild to severe. Most immediate reactions are caused by the body not having the enzymes to digest the lactose sugar and the intestines contract as a reaction. If people have had an ongoing intolerance more extreme headaches, migraines or bloating can occur over the course of up to two days from these undigested particles entering your body, especially if people have a leaky gut.

Lactose maldigestion does not necessarily result in symptoms of lactose intolerance. Most people with lactose maldigestion can eat some lactose-containing foods, such as dairy, without feeling unwell.

Many parents confuse the terms lactose intolerance and milk allergy. While they may share similar symptoms, they are entirely different conditions. Lactose intolerance is a digestive problem, while milk allergy involves the immune system. The child can be tested for milk allergy or lactose intolerance.


Lactose intolerance can happen to children or adults. Here are some common causes of this condition –

  • Lactose intolerance often runs in families (hereditary). In these cases, over time a person’s body may make less of the lactase enzyme. Symptoms may occur during the teen or adult years.
  • In some cases the small intestine stops making lactase after an injury or after a disease or infection.
  • Some babies born too early (premature babies) may not be able to make enough lactase. This is often a short-term problem that goes away.

An illness that involves or injury the small intestine may cause less of the lactase enzyme to be made. Treatment of these illnesses may improve the symptoms of lactose intolerance. These may include –

  • Surgery of the small intestine
  • Infections in the small intestine (This is most often seen in children)
  • Diseases that damage the small intestines, such as celiac sprue or Crohn’s disease
  • Babies may be born with a genetic defect and are not able to make any of the lactase enzyme.

Risk Factors

In the United States, some ethnic and racial populations are more likely to have lactose intolerance than others, including African Americans, Hispanics/Latinos, American Indians, and Asian Americans. The condition is least common among Americans of European descent.

  • Increasing age – Lactose intolerance usually appears in adulthood. The condition is uncommon in babies and young children.
  • Premature birth – Infants born prematurely may have reduced levels of lactase because the small intestine doesn’t develop lactase-producing cells until late in the third trimester.
  • Diseases affecting the small intestine – Small intestine problems that can cause lactose intolerance include bacterial overgrowth, celiac disease and Crohn’s disease.
  • Certain cancer treatments – If some have received radiation therapy for cancer in the abdomen or have intestinal complications from chemotherapy, people have an increased risk of lactose intolerance.

Foods high in lactose

The most common high-lactose foods include –

  • Milk, milkshakes and other milk-based beverages
  • Whipping cream and coffee creamer
  • Ice cream, ice milk, sherbet
  • Cheese
  • Butter
  • Puddings, custards
  • Cream soups, cream sauces
  • Yogurt
  • Foods made with milk

Other foods that MAY contain lactose in smaller quantities include –

  • Bread and baked goods
  • Milk chocolate
  • Salad dressings and sauces
  • Breakfast cereals and cereal bars
  • Instant potatoes, soups, rice and noodle mixes
  • Lunchmeats (other than kosher)
  • Candies and other snacks
  • Mixes for pancakes, biscuits, and cookies
  • Margarine
  • Organ meats (such as liver)
  • Sugar beets, peas, lima beans

When buying food, read the ingredients on food labels carefully. Ingredients derived from milk that contain lactose include:

  • Whey
  • Caseinates
  • Nougat
  • Cheese
  • Milk by-products
  • Dry milk solids
  • Lactose
  • Butter
  • Curds
  • Yogurt
  • Dry milk powder


A symptom is something the patient feels and reports, while a sign is something other people, such as the doctor detect. For example, pain may be a symptom while a rash may be a sign.

Typically, a person with lactose intolerance will experience symptoms after consuming milk or some dairy product that contains lactose. Symptoms may include –

Flatulence – a buildup of excessive gas in the intestinal tract; this can lead to farting and burping.

  • Diarrhea – an hour or two after consuming lactose the individual can suddenly become desperate to go to the toilet.
  • Bloated feeling
  • Stomach ache and abdominal pains
  • Tummy rumbles
  • Nausea
  • Dehydration – if symptoms are severe


If a person comes from a dairy-friendly society and tries to avoid lactose-containing products, he/she will have to make sure their move does not result in malnutrition. Milk contains calcium, proteins, vitamins A, B12 and D – all important nutrients for good health.


Cutting lactose out of the diet is an option, but patients should make sure they aren’t depriving themselves of calcium and vitamin D, Balzora said.

Over-the-counter pills or drops that contain lactase can be taken before meals to help alleviate or eliminate symptoms. For example, Lactaid pills or Lactaid milk allow many people to process dairy products without any difficulty, Balzora said. Some people find that taking probiotics can help them digest lactase better, but Lactaid is really the standard, Balzora said.

Note the following dietary considerations in patients with lactose intolerance –

  • Patients should read labels on commercial products.
  • Patients should avoid or reduce intake of lactose-containing foods.
  • Most patients who are lactose intolerant can ingest as much as 240 mL of milk without an exacerbation of their symptoms.
  • Whole milk and chocolate milk may be better tolerated than skim milk.
  • Certain medications and foods contain hidden lactose, such as breads, margarine, salad dressings, and candies.

Alternative Treatment

Probiotics are living organisms present in your intestines that help maintain a healthy digestive system. Probiotics are also available as active or “live” cultures in some yogurts and as supplements in capsule form. They are sometimes used for gastrointestinal conditions, such as diarrhea and irritable bowel syndrome. They may also help your body digest lactose. Probiotics are generally considered safe and may be worth a try if other methods don’t help.

Lactase supplements are a small pill that is taken with foods containing lactose. They are useful as a temporary measure or when you are eating large quantities of dairy foods, but may not be so good for the long term. Adding the enzymes to milk a few hours before drinking it helps break down the lactose. You can get them from health food stores.

Acidophilus milks are made by adding Lactobacillus acidophilus to cold milk. Many of the studies that have looked at acidophilus milks for lactose digestion have found no improvement. Researchers have speculated that it may be because the acidophilus products used in the studies did not contain enough live acidophilus.

Vitamin K plays a major role in calcium absorption and bone health, but its benefits do not end there. It also helps brain function, metabolism, and helps regulate hormones. This fat-soluble vitamin is stored in the liver, and proper levels can be disrupted by antibiotic use, certain prescription cholesterol medications, and by IBS and leaky gut.

Gentian – This family of some 180 plants, originating in Europe, helps to tone the digestive system and alleviate symptoms of dyspeptic complaints.

Pau d’arco – The bark of this South American tree has long been used to treat candida infections and reinstate good gut flora.

St Mary’s thistle – Used as a traditional medicine for more than 2,000 years, it protects the liver and is often used to support the body’s detoxification processes.

Liquorice – Used in both conventional and naturopathic medicine to aid digestion. However, liquorice also increases blood pressure, so people with hypertension should seek medical advice before taking it.



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