Lightening Lactose Intolerance

You just had a bowl of cereal with milk an hour ago. You are left with nausea, gas, diarrhea, the works. This isn’t the first time you felt this way. You might be lactose intolerant.

Lactose (milk sugar) intolerance is when there is too little of the enzyme lactase in your intestinal tract. Lactase is an enzyme in the digestive tract that breaks down milk sugar so it can be absorbed.

Approximately 65 percent of the human population has a reduced ability to digest lactose after infancy. Lactose intolerance in adulthood is most prevalent in people of East Asian descent, with 70 to 100 percent of people affected in these communities. Lactose intolerance is also very common in people of West African, Arab, Jewish, Greek, and Italian descent.

The condition, is also referred to as lactose malabsorption, is harmless but definitely uncomfortable.

People who ingest milk may come down with stomach cramps, pain, and have diarrhea shortly after milk sugar arrives in their small intestine. People don’t outgrow this deficiency. But you can have low levels of lactase and still be able to digest milk products. If your levels are too low you become lactose intolerant, leading to symptoms after you eat or drink dairy.

It is important to note that symptoms can be managed effectively without giving up dairy foods.

Common signs and symptoms of lactose intolerance are bloating, diarrhea, gas, nausea and sometimes vomiting. The symptoms usually show up 30 minutes or up to two hours after ingesting dairy.

Lactose intolerance occurs when your small intestine doesn’t produce enough of an enzyme (lactase) to digest milk sugar (lactose). Usually, lactase turns milk sugar into two simple sugars, glucose and galactose, which are absorbed into the bloodstream through the intestinal lining.

With lactose intolerance, lactose in your food moves into the colon instead of being processed and absorbed. In the colon, normal bacteria interacts with undigested lactose, causing signs of lactose intolerance.

There are three types of lactose intolerance. In primary lactose intolerance, the most common type, people start life producing enough lactase. Infants, who get their nutrition from milk, need lactase. As children replace milk with other foods, the amount of lactase they produce is decreased, but still high enough to digest the amount of dairy in a typical adult diet. In primary lactose intolerance, lactase production drops off sharply by adulthood, making milk products difficult to digest.

Secondary lactose intolerance is when your small intestine decreases lactase production after an illness, injury or surgery involving your small intestine. Diseases linked to secondary lactose intolerance are celiac disease, intestinal infection, bacterial overgrowth, and Crohn’s disease. Treatment of underlying conditions may restore lactase levels and improve signs and symptoms, but it may take time.

Congenital or developmental lactose intolerance describes when babies are born with lactose intolerance caused by a lack of lactase. This disorder is passed from generation to generation in a pattern of inheritance called autosomal recessive, meaning both the mother and father must pass on the same gene variant for a child to be affected. Premature infants can also be lactose intolerant due to an insufficient lactase level.

Factors that put you at risk for developing lactose intolerance are increasing age (the disorder tends to show up in adulthood); ethnicity (lactose intolerance is common among people of African, Asian, Hispanic, and American Indian descent); premature birth (infants born prematurely might have reduced levels of lactase because the small intestine doesn’t develop lactase-producing cells until the third trimester); diseases affecting the small intestine (like bacterial overgrowth and Crohn’s disease); and certain cancer treatments (if you have had radiation therapy or intestinal complications, your risk of developing lactose intolerance increases).

Your doctor may be able to tell you if you are lactose intolerant if you undergo a hydrogen breath test and a lactose intolerance test. In the hydrogen breath test, you will have to drink a liquid with a high lactose content and your doctor will measure the amount of hydrogen in your breath at regular intervals. Breathing out too much hydrogen means you aren’t fully digesting and absorbing lactose.

In the lactose intolerance test, two hours after drinking a liquid with high levels of lactose, you will undergo blood tests to measure the amount of glucose in your bloodstream. If the glucose level doesn’t increase, it means the body isn’t properly digesting and absorbing the lactose-filled drink.

To lower the amount of lactose you consume in your diet you should limit milk and dairy products, include small servings of dairy products in your meals, eat and drink lactose-reduced ice cream and milk, and add a liquid or powder lactase enzyme to milk to break down the lactose.

There is some concern that limiting or eliminating dairy products could lower the amount of calcium in your body. You can get calcium from other food sources such as almonds, broccoli, leafy green vegetables, and canned salmon or sardines.

There may be a way to enjoy dairy foods. By introducing dairy foods a little at a time, you might be able to ward off major lactose intolerance symptoms. This means saving milk for mealtimes, smaller servings of dairy products, and experimenting with different types of dairy products. Probiotics may also be helpful and aid in digestion.

If you think you might be lactose intolerant, try cutting out dairy products for a few days just to see how you feel. If you notice improvement, try limiting the amount of dairy you eat or drink.

Lactose intolerance doesn’t necessarily mean an end to enjoying dairy. Moderation is key and learning not to go overboard. Consult your doctor if you have questions concerning this disorder.