5 Things You Need to Know About Lactose Intolerance

By Barbara Pierce

The term “lactose intolerance” has been thrown around the health and food world, confusing the condition with various other terms and diets. Lactose is the natural sugar found mostly in milk and milk products, including cheese, ice cream and yogurt. Lactose intolerance means your body can’t digest lactose. The unabsorbed lactose moves onto the large intestine where it is fermented by bacteria, which causes a buildup of gas and water.

To help clear up the confusion, registered dietitian Madisyn Becker of the Mohawk Valley Health System’s Eat Right Live Right nutritional counseling program offers these facts:

1 — Symptoms

Symptoms of lactose intolerance are stomach-related, explained Becker. “Bloating, cramping, diarrhea and rashes,” she said.

Rashes, which can appear within minutes of having even a small amount of a diary product, include raised red bumps of skin, hives, itchy, red, weeping or crusty rash of the skin, or swelling of the face.

When lactose moves through the large intestine (the colon) without being properly digested, it can cause these symptoms. Some people with lactose intolerance cannot digest any milk products; others can eat or drink small amounts of milk products or certain types of milk products without problems. Some don’t experience any symptoms at all.

The severity of symptoms can range from mild to severe. The severity depends on how much lactose you consumed and how much lactase your body has made.

2 — Diagnosis

If you think you may have lactose intolerance, the first thing to do is to make sure the diagnosis is definitive, said Becker.

“Though it’s a fairly common condition, the symptoms can often be linked to other gastrointestinal conditions,” she said.

Other conditions, such as irritable bowel syndrome, celiac disease, inflammatory bowel disease or small bowel bacterial overgrowth can cause symptoms similar to those of lactose intolerance.

To get a positive test for lactose intolerance, your health care professional may do a hydrogen breath test, a blood test or a lactose elimination diet, said Becker.

If you wish to do a lactose elimination diet at home, avoid any foods containing dairy products for three weeks. Then gradually reintroduce small quantities of dairy products, one at a time. If your symptoms reappear, you know that you’re lactose intolerant.

3 — Causes

When your body isn’t able to break down lactose, we often don’t know why this happens, said Becker. You could be born with it, or it could be caused by your environment. The condition becomes more common as we age. It usually develops during the teen and adult years.

Lactose intolerance most commonly runs in families. It occurs more often in Native Americans and people of Asian, African and South American descent than among people of European descent.

Out of the world’s population, 70% have some variation of intolerance.

Sometimes the small intestine stops making lactose after a short-term illness like the flu or as part of a lifelong disease such as cystic fibrosis. Intestinal diseases such as celiac disease and inflammatory bowel disease, surgery, or an injury to your small intestine can also cause lactose intolerance. Lactase levels may be restored if the underlying disorder is treated.

4 — Challenge

The big challenge for people who are lactose-intolerant is learning how to eat to avoid discomfort and still get enough nutrients. “There are many options for you to still have the foods that you enjoy, and the nutrients,” said Becker. “We all need calcium and vitamin D. Our bodies need these good minerals.”

For example, if you especially like milk, choose a different type, like soy milk, nut milk, (such as almond, cashew, or coconut) or Fairlife lactose-free milk, she said.

“A lot of ice creams are lactose-free, as are many cheeses. Fermented cheeses, hard cheeses are better, like parmesan, cheddar, or Swiss are good as they’re lower in lactose. Use plant-based butter, on your bread as well as for baking and cooking,” she added.

It’s important to read to food labels, she suggested. Many foods that you would not expect to contain milk may actually contain milk and lactose, such as salad dressings, frozen waffles, non-kosher lunch meats, sauces, dry breakfast cereals, baking mixes and many instant soups.

5 — Treatment

Lactose intolerance cannot be prevented. The symptoms of lactose intolerance can be prevented by eating less milk and milk products.

Becker suggested that probiotics can be helpful to ease the symptoms of lactose intolerance. Yogurt is usually easier to tolerate because it contains probiotics. Probiotics (known as lactic acid bacteria) are bacteria that restore the balance of “good” bacteria in your digestive system.

Top image: Registered dietitian Madisyn Becker of the Mohawk Valley Health System. “Though [lactose intolerance] is a fairly common condition, the symptoms can often be linked to other gastrointestinal conditions,” she says.