By Sue Smith
Q: I might be lactose intolerant. Can you tell me about this condition and what I can do about it?
A: Lactose intolerance is a very common condition in which someone has difficulty digesting lactose, a sugar found in milk and milk products. This condition occurs when the small intestine doesn’t produce enough of an enzyme called lactase. Lactase converts lactose into smaller sugar molecules that are absorbed into the bloodstream. If lactose cannot be processed by lactase in the small intestine, it moves to the colon where bacteria act on it resulting in the release of gases that cause unpleasant symptoms.
Lactose intolerance often runs in families and is especially prevalent among Asian Americans, African Americans, Mexican Americans and Native Americans. The condition typically begins in the teen or early adult years, and tends to progress slowly. Occasionally lactase deficiency is seen at birth. Rarely, lactose intolerance follows an intestinal injury or infection, and may be temporary in this case.
Symptoms usually start about 30 minutes to two hours after eating or drinking food/drinks containing lactose. Symptoms include gas, diarrhea, bloating, abdominal pain and nausea. The severity of symptoms depends on how much lactose was ingested.
Diagnosis of lactose intolerance is based on a history of symptoms following ingestion of lactose. Tests can be done to confirm the diagnosis. The lactose tolerance test measures your body’s response to a drink high in lactose by checking blood sugar levels — if levels don’t rise, the body isn’t digesting lactose properly. The hydrogen breath test looks for high levels of hydrogen — this may indicate lactose intolerance. The stool acidity test is used for infants and young children — those who are lactase deficient will have lactic acid in their stool.
Lactose intolerance is primarily managed through dietary changes. Many lactose-intolerant people can limit intake of dairy products and keep symptoms at bay. Others may need to completely eliminate lactose-containing foods/drinks. Milk products such as butter, cheese, powdered milk and whey are obvious culprits and should be considered for elimination. Often, avoidance of only a few of these items is enough to control the condition.
Tips for the lactose intolerant:
- Read food/supplement labels, since lactose is often added to nondairy foods/supplements.
- Let your pharmacist know about your intolerance as lactose is found in many medications.
- A food diary can be helpful when trying to determine which foods are most problematic.
- Lactose-free milk products are available in most supermarkets.
- Hard cheeses like Parmesan often have no lactose.
- OTC lactase supplements taken before meals may be helpful.
Finally, always consult a health care provider if your symptoms become unmanageable.
Sue Smith volunteers with the Grillo Center, which offers free, confidential research to assist in health understanding and decisions. To use this service, contact us at grillocenter.org, 720-854-7293 or 4715 Arapahoe Ave., Boulder. No research or assistance should be interpreted as medical advice. We encourage informed consultation with a health practitioner.
Where to find it
American Gastroenterological Association
Google: aga lactose intolerance
Johns Hopkins Medicine
Google: johns hopkins lactose intolerance
National Institute of Diabetes and Digestive and Kidney Diseases
Google: niddk lactose intolerance
National Health Service
Google: nhs lactose intolerance