A health condition in which the body no longer produces an enzyme that breaks down lactose (the sugar in milk) is called lactose intolerance. It also causes digestive distress when a person eats dairy products. It is important to understand that this health problem is different from a food allergy.
In other words, lactose intolerance is a reaction of the digestive system to lactose. People with this condition who eat dairy products can experience unpleasant symptoms. While there are many people who have lactose intolerance, some of them do not experience noticeable symptoms.
What is The Difference between Lactose Intolerance and Lactose Malabsorption?
Almost everyone who has lactose intolerance has lactose malabsorption. However, not everyone who has lactose malabsorption has lactose intolerance. Experts explain this as malabsorption occurs in the first part of the small intestine, but the symptoms of lactose intolerance occur later in the large intestine. In normal circumstances, most nutrients from food are absorbed through the small intestine. The food that is not absorbed passes to the large intestine. Moreover, undigested sugar molecules in the large intestine often produce more water and gas. As a result, it triggers the colon (large intestine) to release extra fluid to help it pass through. Thus, it may lead to diarrhea and gas pain.
Types of Lactose Intolerance
Physicians have divided this condition into 3 categories. These include:
- Primary – This form is often caused by reduced lactase production in the small intestine.
- Secondary – In such cases, a disease or injury causes damage to the small intestine, which leads to lactose intolerance.
- Congenital – This condition is often present at birth, and it causes lactase deficiency.
- Developmental – It usually happens due to premature birth because the small intestine is not fully developed.
Symptoms
Mostly, people who develop lactose intolerance experience the following symptoms. These include:
- Bloating
- Nausea
- Vomiting
- Stomach cramps or pain
- Diarrhea
- Intestinal gas
- Stomach rumbling or gurgling
Usually, the symptoms of lactose intolerance appear within 2 days after eating dairy products. In any case, if any of the previous symptoms occur without an obvious reason, do not hesitate to see a doctor.
What Foods Trigger Lactose Intolerance Symptoms?
In general, lactose is present in most dairy products until it is removed. For example, the cow’s milk and the goat’s milk products. While some of them contain more lactose, others, such as hard cheeses, have less. Moreover, some people can be more sensitive to lactose and experience symptoms even to a small amount of lactose. That’s why it is recommended to check the labels of products all the time if you have lactose intolerance. In addition, lactose can also be present in processed foods (including soups, salad dressings, and snack foods) and some prescription medications.
Causes
In general, lactose intolerance happens due to lactose malabsorption and intestinal sensitivity. The most significant factor is lactose malabsorption. It indicates the inability of the small intestine to break down lactose and absorb it.
Lactase Deficiency
In normal circumstances, there is a specific enzyme (lactase) in the small intestine that breaks down lactose. It helps the small bowel to absorb lactose. Most of the time, people start to produce less lactase over time. When lactase levels are reduced, the small intestine cannot absorb lactose, which often causes symptoms.
Intestinal Sensitivity
This is another factor that contributes to lactose intolerance. In general, all people consume something that cannot be fully digested. For instance, there are some dietary fibers and sugars that feed the bacteria in the intestine. Furthermore, some people can be more sensitive to lactose because they have different bacteria in their gut.
Can You Develop Lactose Intolerance Over Time?
Commonly, people develop this condition when they grow from childhood to adulthood. Furthermore, they develop primary lactose intolerance because the body produces less lactase, which helps digest lactose. It often happens due to changes in the bowel sensitivity that also occur gradually over time. People who have any of the following conditions are more likely to experience symptoms. These include:
- Small intestinal bacterial overgrowth
- Irritable bowel syndrome
- Visceral hypersensitivity
When People Become Suddenly Lactose Intolerant?
Sometimes, people develop secondary lactose intolerance. It happens when something damages the small intestine. For example, surgery, infections, chronic health conditions, or injuries can cause damage to the cells that produce lactase. As a result, it leads to sudden lactose malabsorption and intolerance. Check some causes of secondary lactose intolerance below:
- Cystic fibrosis
- Celiac disease
- Enterocolitis
- Small bowel resection
- Radiation therapy
- Inflammatory bowel disease (IBD)
Some people may regain the ability to digest lactose by treating the underlying condition.
What Are The Potential Complications of Lactose Intolerance?
People who leave this condition untreated may also experience some complications. Check some of them below:
- Bone health problems – For example, osteopenia, increased risk of fractures, osteoporosis (brittle bones), and others.
- Nutritional deficiencies – Usually, people who have lactose intolerance should find alternatives to ensure an adequate amount of vitamin D and Calcium. Otherwise, it may negatively affect your muscles and nerves.
- Chronic gastrointestinal issues – People who continue to consume lactose despite their condition may experience diarrhea, bloating, gas, and abdominal pain.
- Malnutrition and weight loss
- Inflammation
This document does not contain a full list of lactose intolerance complications. However, you can consult with your physician about ways to reduce the risk or even prevent them.
Diagnosis
Usually, people suspect lactose intolerance when they experience symptoms after eating dairy products. In any case, it is advised to see a doctor for a diagnosis. Check below some tests that are often used by doctors to determine whether you have lactose intolerance:
- Hydrogen breath test – During this test, doctors will measure the amount of methane gases in your breath. These gases are produced by the bacteria in your colon. Increased levels of methane in your breath may indicate lactose intolerance.
- Blood sugar test – This test is used to measure the sugar content in the blood before and after eating products that contain lactose. Usually, doctors perform it when the hydrogen breath test is inconclusive.
- Stool acidity test – Doctors often perform this test for small children and infants. To perform it, doctors will take a sample of stool after feeding your child lactose.
Treatment
Generally, to digest lactose, people need lactase in their intestines. Most of the time, physicians recommend lactase supplements that are taken before eating products that contain lactose. Furthermore, researchers perform experiments with lactic acid bacteria that may help reduce lactose intolerance symptoms. These bacteria are used to convert lactose into lactic acid instead of gas. Commonly, doctors also recommend starting a lactose-free diet and then gradually adding products that contain lactose to see how your digestive system responds. Although some people can tolerate about 12 grams of lactose at one time, you can find lactose-reduced or lactose-free options of most dairy products at the supermarket.
Frequently Asked Questions
Can lactose intolerance go away?
While people with secondary lactose intolerance may recover the ability to produce lactase, those who develop the primary and congenital types of this condition would not be able to produce lactase naturally. For more details, discuss it with your doctor.
What happens if you ignore lactose intolerance?
While lactose intolerance symptoms do not cause serious health problems, they may lead to unpleasant symptoms, including persistent diarrhea, bloating, and abdominal (belly) pain. In any case, you can prevent these symptoms by choosing lactose-free dairy products.
What is lactose malabsorption?
This medical term is used to describe the inability to break down and absorb lactose molecules in the digestive system. Moreover, it is a common condition that affects about 65% of people in the world. Additionally, unabsorbed lactose passes undigested through the gastrointestinal tract, causing symptoms.
Can people with lactose intolerance eat any dairy products?
Yes, many people with lactose intolerance can tolerate small amounts of dairy, especially products that are lower in lactose. For example, hard cheeses and yogurt are often easier to digest. Tolerance levels vary, so individuals may need to experiment to determine what works best for them.
Are there non-dairy alternatives that provide enough calcium?
Yes, there are many non-dairy options that can help meet calcium needs. These include fortified plant-based milks (such as almond, soy, or oat milk), leafy green vegetables, tofu, almonds, and fortified cereals. Choosing calcium-rich alternatives is important for maintaining bone health.
How can I tell if my symptoms are caused by lactose intolerance or another condition?
Because symptoms of lactose intolerance can overlap with those of other digestive disorders, such as irritable bowel syndrome (IBS), it is important to monitor when symptoms occur, especially after consuming dairy products. Keeping a food diary and consulting a healthcare provider can help confirm the diagnosis and rule out other conditions. Ask your healthcare provider if you have any other questions.
