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What is Lactose Intolerance


Lactose intolerance is a condition that affects some people when they consume dairy products. Lactose is a sugar found in milk and milk products.

Lactose intolerance occurs when the body doesn’t produce enough of an enzyme, lactase, to break down the lactose.

As a result, the lactose remains in the digestive system where it can cause uncomfortable symptoms, such as bloating, gas, and diarrhea.

Lactose intolerance is a common condition, affecting up to 65 percent of the population. It is more common in people of Asian, African, and Hispanic descent.

However, it can occur in any ethnic group. There is no cure for lactose intolerance, but there are ways to control it.


Lactose Intolerance Symptoms


Lactose intolerance is the inability to digest lactose, a sugar found in milk and milk products. Lactose intolerance is not the same as a milk allergy.

People who are lactose intolerant may have symptoms such as stomach cramps, bloating, gas, nausea, and diarrhea after drinking milk or eating milk products.

These symptoms can vary from person to person and may not occur in everyone who is lactose intolerant.

If you think you may be lactose intolerant, talk to your doctor. He or she can do a test to see if you have a problem digesting lactose.

There are a number of ways to manage lactose intolerance. You can try to avoid milk and dairy products.

The signs and symptoms of lactose intolerance usually begin from 30 minutes to two hours after eating or drinking foods that contain lactose.

Common signs and symptoms include:

  • Diarrhea
  • Nausea
  • Vomiting
  • Stomach cramps
  • Bloating
  • Gas

What Causes Lactose Intolerance?


Primary Lactose Intolerance
Primary lactose intolerance is caused by a decrease in lactase production with age. With primary lactose intolerance you lose the ability to absorb lactose over time.

This form of lactose intolerance may be partially genetic since it’s more common in some populations.

If you experience bloating, gas, and diarrhea after drinking milk or eating dairy products, you may have primary lactose intolerance.

This means you don’t have enough of the enzyme lactase to break down lactose, the sugar in milk.

You can still eat some dairy products if you have primary lactose intolerance, but you’ll need to experiment to find out which ones work best for you.


Secondary Lactose Intolerance
Secondary lactose intolerance, however, is a condition that is not as well-known, but can be just as debilitating.

Secondary lactose intolerance is a condition that results from damage to the small intestine that has been caused by another illness or injury.

This damage can prevent the small intestine from properly breaking down lactose, causing the symptoms of lactose intolerance.

Secondary lactose intolerance can be treated by avoiding dairy products and taking lactase supplements to help the small intestine break down lactose.


Congenital Lactose Intolerance
Congenital lactose intolerance is present in newborns.  Congenital lactose intolerance is a rare genetic disorder that interferes with the digestion of lactose, a sugar found in milk and other dairy products.

Infants with this disorder are unable to break down lactose, so the sugar remains in their digestive system, where it can cause cramps, bloating, and diarrhea.

Treatment for congenital lactose intolerance typically includes a lactose-free diet.



How To Diagnose Lactose Intolerance

Symptoms of lactose intolerance include abdominal pain, bloating, gas, nausea, and diarrhea.

The best way to diagnose lactose intolerance is to eliminate milk and milk products from your diet for a week or two and then reintroduce them.

If your symptoms return when you eat milk and milk products, you are likely lactose intolerant.

There are several tests that can be used to confirm a diagnosis of lactose intolerance such as:

Hydrogen Breath Test
Many people who experience gastrointestinal problems such as bloating, excessive gas, and abdominal pain turn to hydrogen breath tests as a way to diagnose the root of their discomfort.

During a hydrogen breath test, a person drinks a beverage that is laced with sugar and a small amount of hydrogen.

If the person has an overgrowth of bacteria in their small intestine, the bacteria will break down the sugar and release hydrogen gas.

This gas is then exhaled and detected by a machine that measures the level of hydrogen in the breath.

A hydrogen breath test can help identify conditions such as small intestine bacterial overgrowth, lactose intolerance, and fructose malabsorption.

Blood Test
A blood test can determine if you are lactose intolerant. The test measures the amount of lactose in your blood after you drink a lactose-containing beverage.

If your blood sugar level doesn’t rise as expected, you are likely lactose intolerant.



Treatments for Lactose Intolerance

What Foods Contain Lactose?
Living with lactose intolerance, the most important thing is to avoid foods that contain lactose.

These include:

  • Milk
  • Cheese
  • Yogurt
  • Ice cream

There are many foods that do not contain lactose, including many fruits and vegetables, meat, fish, eggs, legumes, nuts, and grains.

Dietary Changes
Swap your usual rice or pasta side dish for a colourful salad.

Instead of eating processed snack foods, snack on vegetables such as carrots, snow peas or cherry tomatoes along with a spicy hummus dip or peanut butter

How to Start Recovering from Lactose Intolerance

If you’re suffering from lactose intolerance, starting the recovery process is essential. By using the following nine tips, you can get back on track quickly.

Probiotics and prebiotics are beneficial microorganisms that help improve your health.

Prebiotics are types of fiber that provide food for these microorganisms, while probiotics are the microorganisms themselves.

Studies have shown that both probiotics and prebiotics can help reduce symptoms of lactose intolerance. 


How Can Lactose Intolerance be Prevented?

Lactose intolerance is caused by a lack of lactase, the enzyme that breaks down lactose.

Lactose intolerance can be prevented by eating foods that are low in lactose or by taking lactase supplements before eating foods that contain lactose. Lactase supplements are available over the counter.



What Are the Risks of Lactose Intolerance?

While it is not dangerous, it can be very unpleasant. For people who are lactose intolerant, it is best to avoid dairy products and to find alternative sources of calcium.



How To Live with Lactose Intolerance

If you’re one of the estimated 65 percent of the world’s population who suffers from lactose intolerance, you know that avoiding dairy can be challenging.

From cheese to milk to yogurt, dairy is everywhere. But what are the risks of lactose intolerance? How can you live with it?

Ways to change your diet to minimize symptoms of lactose intolerance include:

  • Choosing smaller servings of dairy
  • Saving milk for mealtimes
  • Experimenting with an assortment of dairy products
  • Buying lactose-reduced or lactose-free products
  • Using lactase enzyme tablets or drops




Think You Might be Lactose Intolerant?

If you are frequently experiencing symptoms like nausea, cramps, bloating, and diarrhea after consuming dairy products, it is important to consult with your doctor.

This is particularly relevant if you are concerned about getting enough calcium in your diet.

There are a variety of ways to get the recommended daily intake of calcium, including consuming dairy products that have been specially treated to reduce lactose.

Dr. Deetlefs is a gastroenterologist expert using patient-focused GI treatment and procedures in Cape Town.

Get in touch with Dr. Deetlefs for any gastrointestinal disorders or concerns you might have.

Make your appointment now.


The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a Gastroenterologist or medical doctor regarding ANY and ALL symptoms or signs including, but not limited to: abdominal pain, haemorrhoids or anal / rectal bleeding as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today and schedule a consultation.

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© Dr. Eduan Deetlefs, Registered Gastroenterologist, GI Doc Cape Town

Our website information is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a doctor about your specific condition. Only a trained physician can determine an accurate diagnosis and proper treatment.