Lactose Intolerance: Symptoms, Diagnosis, Treatment

Does a glass of milk get you running to the toilet? If you experience bloating, gas, diarrhoea and abdominal pain after drinking milk or consuming milk or milk products, these may be lactose intolerance symptoms. All dairy products have lactose or sugar in them, and if we are lactose intolerant, our body cannot fully digest these. This digestive disorder is due to the absence of an enzyme called lactase in the body. This might be genetic or can be caused due to other illnesses. While there is no treatment for lactose intolerance, consuming lactose-free products and keeping away from dairy products that contain lactose such as cow’s milk, yoghurt, cheese and ice cream, is the way to manage this condition.

What is Lactose Intolerance?

Lactose intolerance is a common digestive issue in which the body has difficulty breaking down lactose, the sugar present in milk and dairy products, explains dietitian Veena V. This is because there is not enough lactase which is an enzyme that breaks down lactose found in the small intestines. The lactose that cannot be digested by the body, passes into the colon. The bacteria in the colon, break the lactose down, and this results in extra fluid as well as gas, which causes lactose intolerance, states the US National Institute of Diabetics and Digestive and Kidney Diseases.

What are the symptoms of lactose intolerance?

Lactose intolerance can be very uncomfortable and can cause a range of symptoms.

• Bloating
• Gas
• Diarrhea
• Abdominal pain

Additionally, some people may feel nauseous or even vomit. The UK’s NHS also adds other symptoms such as rumbling of the stomach and feeling sick. It also states that these indicators surface in a few hours after taking lactose and their intensity varies depending on how much was consumed as well as individuals’ level of deficit in lactase production. Some people can drink a small glass of milk, without showcasing symptoms, while others might not be able to digest milk in their coffee or tea.

Also Read: Food intolerance: Signs and tips to manage it

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Types of lactose intolerance and their causes

There are three types of lactose intolerance with varying symptoms:

1. Primary lactose intolerance

This is a natural consequence of ageing. The amount of lactase our body makes may decrease with age, as we eat other things, and don’t drink too much milk. Therefore, our body no longer relies on it.

2. Secondary lactose intolerance

This is when diseases such as celiac disease, inflammatory bowel disease, or surgery or injury can lead to lactose intolerance. In this case, the underlying cause needs to be treated. Diseases like gastroenteritis or chemotherapy treatments also can temporarily reduce lactase production and it may lead to lactose intolerance.

3. Congenital and Developmental lactose intolerance

In the case of congenital lactose intolerance, a person is born lactose intolerant. This is due to genetics. Here, the baby cannot drink breast milk as well. Developmental lactose intolerance can happen if the baby is born prematurely, before 34 weeks.

How is lactose intolerance diagnosed?

For diagnosis purposes, several methods can be used such as the following:

1. Lactose tolerance test

Here, you may be given a drink rich in lactose. This will be followed by measuring blood glucose for hypoglycemia. Based on your levels, it is determined whether you are lactose intolerant or not.

2. Hydrogen breath test

This test measures the amount of hydrogen present in your breath after you consume a high-lactose drink. This indicates bacterial fermentation. If you are lactose intolerant, the hydrogen levels will be higher.

3. Intestinal biopsy

Here, multiple tissue samples are taken from lower endoscopy or upper gastrointestinal endoscopy. The lactase enzyme is measured in the biopsy specimen, states this study, published in the Journal of Neurogastroenterology and Motility.

4. Stool acidity test

A stool acidity test can also be used, especially for infants and young children, to detect undigested lactose in the stool. It measures lactic acid in the stool sample.

5. Genetic tests

The genetic test assists in the diagnosis of primary lactose intolerance. The genetic test is performed on a routine blood sample. “If the genetic variant is absent, the patient may have difficulties metabolising milk and milk products and have symptoms arising from this. Dietary exclusion of dairy products may be considered in this situation,” explains Veena.

What is the treatment for lactose intolerance?

The treatment of lactose intolerance includes dietary modifications, lactase supplementation and treating underlying conditions, states this research published by StatPearls. To control the symptoms, lactose intolerant people have to undergo a special type of therapy that changes their diet. This may entail taking away or decreasing foods and drinks that contain lactose. “The supplements which contain lactase enzyme can also be used in breaking down the milk sugar present in dairy products. For some individuals, they must consume dairy products without lactose or non-dairy alternatives made from plants,” says Veena.

Probiotics with proven efficacy such as Bifidobacterium, Saccharomyces, and Lactobacillus, have been shown to reduce symptoms of lactose intolerance when used as a daily supplement.

When is lactose intolerance serious?

Lactose intolerance is not usually life-threatening. However, severe symptoms can interfere with a person’s quality of life and cause malnutrition when essential nutrients are not adequately replaced after removing dairy from the diet. “In case of persistent or worsening symptoms, one should seek medical advice from a healthcare provider who will rule out other possible digestive system disorders,” says Veena.

Lactose intolerance diet

People suffering from lactose intolerance must avoid or reduce their intake of milk, cheese, and ice cream because they have high levels of this sugar compound. They can opt for dairy-free versions or plant-based options like almond milk, soy milk, or oat milk instead. Check out some foods for lactose intolerance.

“Some low-lactose foods such as certain types of cheese (cheddar or Swiss) can be taken in small quantities without causing much harm if at all any occurs,” says Veena. A lactose-free diet is the best way forward.