Lactose intolerance stems from the inability to digest lactose (a sugar found in milk), resulting in stomach cramping, bloating, gas, and foamy, watery diarrhea. Lactose is only found in milk, though it is sometimes added to other foods. Lactose intolerance is very common in African Americans, Asians, Hispanics, and Europeans. It occurs in only about 10% of Caucasians and is particularly uncommon in Scandinavians.
In most patients, the severity of symptoms depends on the quantity of milk consumed. In the most common form of lactose intolerance, symptoms typically begin in the teenage years or young adulthood with a gradual increase in gastrointestinal problems. For most patients the symptoms are not severe — and for many, merely an annoyance. Self-diagnosis often results in avoiding milk products or limiting the amount consumed at one time.
In some patients, the diagnosis may be confused with milk allergy, which is a different disease altogether. Testing for lactose intolerance is practical and simple, although more complex and expensive tests are also available.
Simple Test to Find Out if You Have Lactose Intolerance
- Avoid all milk products for 1–2 weeks
- Keep a baseline diary of GI symptoms during this period
- After the baseline period, challenge yourself with lactose-free milk or yogurt
- If you have no GI symptoms, it is very likely that you have lactose intolerance
- If you still have symptoms after the challenge, you may have milk allergy, or the "lactose-free" product may have contained some lactose
- Work with your doctor regarding treatment and calcium supplements
Milk Allergy vs. Lactose Intolerance
These are two entirely different conditions. Key differences include:
- Milk allergy is common in infants and children but rare in adults; lactose intolerance is rare in infants and young children but common in adults
- Milk allergy is due to an abnormal immune response to milk protein; lactose intolerance is due to a lack of the enzyme that breaks down milk sugar
- Milk allergy may be severe and can involve respiratory congestion, rash, asthma, or shock; lactose intolerance produces GI symptoms only — bloating, gas, and diarrhea
Treatment
- Avoid or limit the quantity and frequency of milk ingestion
- Fresh yogurt and aged cheeses are generally well tolerated
- Yogurt or "lactose-free" milk can be purchased at the supermarket — read labels carefully, as some products still contain some lactose. Look for brands with less than 10% of the original lactose content.
- For those with bothersome symptoms, a lactose enzyme (Lactaid) is available in tablet or liquid form and can be taken just before consuming dairy, or the powdered form can be added directly to milk (most effective)
- If you choose to avoid milk entirely, be sure to obtain calcium from other sources
Remember, milk allergy and lactose intolerance are two entirely different diseases. The only treatment for milk allergy is avoidance. Those with lactose intolerance may consume milk products that are free of lactose.
If you have any questions, contact our office: Omaha: 402-391-1800 Lincoln: 402-464-5969
Call to Schedule an Appointment!
Lincoln: 402.464.5969 Omaha: 402.391.1800
