Lactose Intolerance

People with lactose intolerance need to follow specific dietary guidelines. We provide an overview and suggestions for how to manage this condition.

Brief Overview

People with lactose intolerance are unable to fully digest the sugar (which is called lactose) in dairy products. As a result, they have diarrhea, gas, and bloating after eating or drinking dairy products.

The condition is fairly harmless (although it can impact the amount of calcium you’re getting, which is important), but its symptoms are uncomfortable. And many people with lactose intolerance can mange the condition without having to give up all dairy foods.

A marked deficiency of lactase—an enzyme produced in your small intestine—is usually responsible for lactose intolerance. It’s important to see a doctor if you frequently have symptoms of lactose intolerance after eating foods with dairy.

And as the following video shows, lactose intolerance is different from a milk allergy.

Symptoms

The signs and symptoms of lactose intolerance usually begin 30 minutes to 2 hours after eating or drinking foods that contain lactose. Common symptoms include:

• Diarrhea

• Nausea, and sometimes, vomiting

• Abdominal cramps

• Bloating

• Gas

Dietary Changes

• Limit dairy products.

You may be able to tolerate low-fat milk products, such as skim milk, better than whole-milk products. It is also possible to increase your tolerance to dairy products by gradually introducing them into your diet.

• Choose smaller servings of dairy.

Sip small servings of milk, up to 4 ounces, at a time. The smaller the serving, the less likely it is to cause gastrointestinal problems.

• Save milk for mealtime.

Drink milk with other foods, because this slows the digestive process and may lessen symptoms of lactose intolerance.

• Experiment with an assortment of dairy products.

Not all dairy products have the same amount of lactose. For example, hard cheese, such as Swiss or cheddar, have a small amount of lactose and generally cause little, or no, symptoms. You may be able to tolerate cultured milk products, such as yogurt, because the bacteria used in the culturing process naturally produce the enzyme that breaks down lactose.

• Buy lactose-reduced or lactose-free products.

You can find these products at most supermarkets.

• Eat non-dairy foods that are high in calcium.

Included are: broccoli, salmon, oranges, beans, rhubarb and spinach. Also, some foods like breads and juices are calcium fortified. And there are milk substitutes, such as soy or rice milk.

•Use lactase enzyme tablets or drops, as prescribed by your doctor.

Causes

• Increasing age

The condition is uncommon in babies and young children.

• Ethnicity

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

• Premature birth

Infants born prematurely may have reduced levels of lactase because the small intestine doesn’t develop lactase-producing cells until late in the third trimester.

• Diseases affecting the small intestine

Small intestine problems that can cause lactose intolerance include bacterial overgrowth, celiac disease and Crohn’s disease.

• Certain cancer treatments

Radiation therapy for abdominal cancer, or intestinal complications from chemotherapy, can increase your risk for lactose intolerance.

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