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Milk allergy or Lactose Intolerance?

What is lactose intolerance?

Lactose intolerance is when the body cannot easily digest lactose, a natural sugar found in milk and dairy products. The poor digestion is related to a deficiency in an enzyme called lactase in the small intestine which is needed to break down lactose.  Lactose in the large intestine leads to uncomfortable symptoms such as crampy, stomach pain, gassiness, and bloating.  While some people can’t tolerate any lactose, most persons can tolerate small amounts of lactose or certain types of dairy products. However, once they ingest too much called the “threshold,” symptoms occur!

Lactose intolerance is common in adults. It occurs more often in Native Americans, Asians, Africans, and South Americans.  Lactose intolerance commonly runs in families, and symptoms usually develop during the teen or adult years. Most people with this type of lactose intolerance can tolerate some milk or dairy products without problems.

Sometimes the small intestine stops making lactase after an acute illness such like gastroenteritis (stomach flu) or as part of a disease like cystic fibrosis.  If part of the small intestine is surgically removed, it can stop making lactase.  When a person is born with lactose intolerance, they cannot eat or drink anything with lactose.  Some premature babies have temporary lactose intolerance because they are not yet able to make lactase.  After a baby begins to make lactase, the condition typically goes away.

Symptoms of lactose intolerance can be mild to severe, depending on how much lactase your body makes. Symptoms usually begin 30 minutes to 2 hours after you eat or drink milk products. If you have lactose intolerance, symptoms include:

  • Bloating
  • Stomach pain or cramps
  • Gurgling or rumbling sounds in your belly
  • Gas
  • Loose stools or diarrhea (no blood)
  • Vomiting

Many people with gas, belly pain, bloating, and diarrhea suspect they may be lactose-intolerant. The best way to check is to avoid eating all milk and dairy products and if the symptoms go away, try adding small amounts of milk products back into your diet to see if your symptoms return.  If they do, chances are it is lactose intolerance and you may have found the “threshold” to trigger symptoms.

How so you diagnose lactose intolerance?

Frequently, by asking the right questions about your symptoms and response to avoidance of milk and dairy is sufficient to diagnose lactose intolerance.  If a person has not already tried, then a 2 week elimination diet of milk/dairy to monitor if symptoms are improved can be very helpful.

Sometimes a hydrogen breath test or blood sugar test is used to confirm the diagnosis. These simple tests check to see if a person is digesting lactose normally.

How is lactose intolerance treated?

There is no cure.  Treatment is aimed at minimizing symptoms by limiting or avoiding milk products. Drinking milk with low lactose, or a milk substitute such as soy milk can be helpful.   Some lactose-intolerance people can eat yogurt without problems, especially yogurt with live cultures.  A dietary supplement such as Lactaid that contains lactase can help digest lactose if taken before dairy ingestion.

Next time, we will review milk allergies!

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