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Home > Services > Digestive Health > Digestive Conditions > Lactose Intolerance

Lactose Intolerance

Lactose Intolerance

Lactose intolerance occurs when your body can't digest lactose, a sugar found in milk and other dairy products. When not fully broken down, lactose ferments in the colon and causes symptoms.

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Some people are born unable to make lactase. Others develop the intolerance over time.

Risk

Factors that increase your risk of lactose intolerance include:

  • Black, Asian or Native American race
  • Jewish ethnicity
  • Family history of lactose intolerance
  • Having certain illnesses or conditions that can damage the intestinal tract such as:
    • Gastroenteritis
    • Celiac disease
    • Cystic fibrosis
    • Crohn's disease
    • Chemotherapy

Symptoms of Lactose Intolerance

Symptoms generally begin within two hours of consuming milk or other dairy products. The severity of symptoms depends on how much lactase your body produces and how much lactose you eat.

Lactose intolerance may cause:

  • Cramping
  • Bloating
  • Abdominal rumbling sounds
  • Gas
  • Diarrhea
  • Loose stools

Diagnosis

Your doctor may recommend a trial period of eating no milk or milk products to see if symptoms resolve, or perform tests to help make the diagnosis. These may include:

  • Hydrogen breath test
  • Stool acidity test

Your doctor may recommend a biopsy to examine small intestine tissue.

Treatment

Temporary lactose intolerance following an infection usually goes away after the intestine heals.

Treatment for chronic lactose intolerance focuses on managing symptoms. For most people, removing dietary lactose, especially in children and adolescents, would not be recommended. Milk and milk products provide sources of calcium and other food elements that are hard to replace. If complete elimination is chosen, then careful replacement of calcium is needed for good health.

Dietary Changes

Keep a food diary of what you eat and what the reaction is. Discuss the findings with your doctor or a dietitian.

Dietary changes may include:

  • Eat smaller amounts of milk or milk products with a meal. It may reduce symptoms. Many people can tolerate 4-8 ounces of milk. You may have better tolerance for some of the following dairy products made from milk:
    • Hard cheeses, such as cheddar and Swiss
    • Yogurt
  • Try lactose-free milk and lactose-reduced milk and milk products.
  • Ask a dietitian for help choosing substitutes for dairy products or recommending supplements to ensure that you eat enough calcium.
  • Nondairy foods rich in calcium include:
    • Salmon
    • Sardines
    • Cooked spinach
    • Oranges
    • Broccoli
  • Read product labels because other foods can contain lactose including:
    • Breads
    • Baked goods
    • Processed cereals
    • Instant potatoes, soups, and breakfast drinks
    • Margarine
    • Processed meats
    • Liquid and powder milk-based meal replacements
    • Protein powders and bars
    • Salad dressings
    • Candies
    • Pancake mixes
    • Non-dairy coffee creamers and whipped toppings
  • Other words that indicate lactose are:
    • Whey
    • Curds
    • Dry milk solids
    • Nonfat dry milk
    • Milk by-products
  • Be aware that some medications may contain small amounts of lactose.

Medications

Your doctor may recommend lactase enzymes if you can tolerate only small quantities of lactose. The enzyme supplements come in liquid and chewable form. A few drops of the liquid added to milk, which is allowed to sit overnight, can decrease the amount of lactose in the milk. Tablets are chewed or swallowed before eating foods that contain lactose.

 

Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.

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