Lactose Intolerance

Do you have difficulty digesting a type of carbohydrate contained in milk called lactose?

If yes, keep reading for detailed information on lactose intolerance!

What Is Lactose?

Lactose is a type of carbohydrate contained in milk. It is also known as milk sugar.

Your body uses the lactase enzyme secreted from the small intestines to break down lactose. This enzyme reduces lactose to glucose and galactose, allowing your body to absorb sugar.

What Is Lactose Intolerance?

When the secretion level of the lactase enzyme in your small intestines is low, your body is unable to digest lactose if you consume it. Since lactose cannot be digested in your body, it passes into the large intestine and interacts with the bacteria there. As a result, problems such as diarrhea, gas, and bloating occur after drinking milk and consuming milk products.

Even if you have low lactase levels, you can still digest milk and its products. However, if your enzyme levels drop too low, you may become lactose intolerant after eating dairy products.

This condition, which is also called lactose malabsorption or lactose intolerance, is usually harmless, but its symptoms can negatively affect your quality of life.

Microbiome and Lactose Intolerance

Recent studies revealed that modulation of the gut microbiota, or microbiome, to encourage lactose-digesting bacteria can alleviate the symptoms of lactose intolerance in some people.

In other words, when there is an excess of lactic acid bacteria in the microbiome, these bacteria are observed to digest lactose and produce lactic acid instead of gas. Thus, the health of your microbiome is very important!

Milk Allergy or Lactose Intolerance?

Lactose intolerance is not the same as milk intolerance or milk allergy. Food allergies occur when the immune system reacts to a particular type of food. When your body reacts to a certain food, symptoms such as rash, wheezing, and itching occur.

While even a small piece can be enough to trigger a reaction if you are allergic to something, most people with lactose intolerance can consume small amounts of lactose without any problems, although this varies from person to person.

Symptoms of Lactose Intolerance

Symptoms due to the inability to digest lactose usually appear 30 minutes to 2 hours after eating food containing lactose.

Symptoms of lactose intolerance are as follows:

  • Diarrhea
  • Nausea, vomiting
  • Stomach cramps
  • Bloating
  • Gas
  • Types of Lactose Intolerance
  • Primary Lactose Intolerance

This is the most common type of lactose intolerance. People with this type of lactose intolerance have sufficient lactase enzymes in their bodies in the early stages of their lives.

Lactase, which digests the lactose in breast milk, decreases with the replacement of breast milk with other foods in the later stages of life. While this amount remains high enough for a typical adult to digest lactose, the lactase enzyme suddenly drops in primary lactose intolerance, making it difficult to digest milk and dairy products.

Secondary Lactose Intolerance

This type of lactose intolerance is caused by decreased secretion of the lactase enzyme in the intestines after a disease, injury, or surgery in the small intestine.

Diseases associated with secondary lactose intolerance include intestinal infection, celiac disease, bacterial overgrowth, and Crohn’s disease.

Lactase levels can be restored through treatment of the disease that caused secondary lactose intolerance, thereby improving symptoms.

Congenital or Developmental Lactose Intolerance

The incidence is very low in this type of lactose intolerance, which occurs due to the congenital deficiency of the lactase enzyme.

The disorder is passed on from generation to generation in an inheritance pattern called autosomal recessive. In other words, for a child to be affected by the condition, both mother and father must pass on the same gene variant to their child.

Infants born prematurely may be lactose intolerant due to insufficient lactase levels.

Now let’s take a look at the factors that cause these types of lactose intolerance.

Risk Factors of Lactose Intolerance

Advancing age: Lactose intolerance usually develops in adulthood (20-40 years of age). The incidence of lactose intolerance in infants and young children is rare.

Ethnicity: Lactose intolerance is most common in people of African, Asian, Hispanic, and American Indian descent.

Premature birth: In preterm infants, lactase enzyme levels may be deficient since the small intestine cannot produce lactase-producing cells until late in the third trimester.

Diseases that affect the small intestine: Small intestinal problems that can cause lactose intolerance include bacterial overgrowth, celiac disease, and Crohn’s disease.

Some cancer treatments: Receiving radiation therapy for stomach cancer or experiencing intestinal complications from chemotherapy increases the risk of experiencing lactose intolerance.

Keep reading to learn whether you have lactose intolerance or not!

How Can We Identify Lactose Intolerance?

Your physician may suspect lactose intolerance based on your symptoms and positive responses to reducing the consumption of dairy products in your diet. You can confirm this by taking one or more of the following tests:

Hydrogen breath test: After consuming food with a high level of lactose, your physician will measure the amount of hydrogen in your breath at regular intervals. Inhaling large amounts of hydrogen indicates that you are not fully digesting the lactose.

Lactose tolerance test: The amount of glucose in the bloodstream is measured after two hours of consuming food containing high levels of lactose. No increase in glucose levels means you are not digesting lactose.

How Can Lactose Intolerance Be Treated?

There is no definitive cure for lactose intolerance. However, reducing the consumption of food and drinks containing lactose often helps control symptoms.

In people with lactose intolerance caused by an underlying condition, treating the condition can restore the ability of the body to digest lactose, but this process can take months.

You can control lactose intolerance that is caused by other reasons by following a low-lactose diet.

Here are foods with high lactose levels to be wary of:

  • Milk and cream
  • Condensed and evaporated milk
  • Ice cream
  • Pot cheese
  • Ricotta cheese
  • Sour cream
  • Cheese paste

To reduce the amount of lactose in your diet:

  • Limit the amount of milk and other dairy products,
  • Include small portions of dairy products in your regular meals,
  • Consume ice cream and milk with reduced lactose,
  • Intake the lactase enzyme, which is required to break down lactose, as a supplement.

You can include the following lactose-free foods in your diet:

  • Lactose-free cow’s milk
  • Soy milk, yogurt, cheese
  • Rice, oats, almonds, hazelnuts, coconut, quinoa, and potato milk

Milk and other dairy products contain calcium, protein, and vitamins such as A, B12, and D. Lactose also helps your body absorb a number of other minerals, such as magnesium and zinc. These vitamins and minerals are important for the development of strong and healthy bones. If you have lactose intolerance, these vitamins and minerals may be deficient in your body, therefore, it is beneficial to take calcium and vitamin D supplements under the supervision of a physician!

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