Lactose intolerance is a common digestive disorder.
It occurs when the body is unable to properly digest lactose, a sugar found in dairy products.
Understanding lactose intolerance, its causes, symptoms, and management is useful for those living with the condition.
Lactose intolerance is not a dairy allergy. It occurs when the small intestine doesn't produce enough of an enzyme called lactase. Lactase is necessary for breaking down lactose into two simpler sugars, glucose and galactose, which can be absorbed into the bloodstream.
There are three main causes of lactose intolerance:
1. Gut damage due to surgery, a tummy bug or a condition such as coeliac disease or Crohn’s disease can reduce lactase production. Once the underlying condition is treated, lactose intolerance may resolve.
2. Lactase deficiency, which is the most common cause. Over time, the body naturally produces less lactase and often begins in childhood, but may begin at any time. This is more prevalent in Asian, Middle Eastern, Mediterranean, South American and African people. It may also be more common in Māori and Pasifika people.
3. Developmental lactase deficiency is a rare genetic disorder where a baby is born with little or no lactase enzyme.
The symptoms of lactose intolerance can vary in severity and typically occur 30 minutes to 2 hours after consuming lactose-containing foods or drinks. Common symptoms include: bloating, diarrhoea, abdominal cramps, gas, nausea.
To diagnose lactose intolerance it is important to see your GP, rather than self-diagnosing. Cutting out dairy products without dietary advice may mean you miss essential nutrients, such as calcium and vitamin D. The condition is usually diagnosed with a trial of taking lactose out of your diet to see if your symptoms disappear. It is then re-introduced at a later stage to find out how much lactose you can tolerate. Other tests for diagnosis are a lactose intolerance test or hydrogen breath test. These are not sensitive or specific enough to provide an accurate diagnosis, so they are not widely used.
Living with lactose intolerance doesn't mean completely avoiding all dairy products. There are several strategies for managing the condition:
• Over-the-counter lactase enzyme supplements taken before consuming dairy products to help digest lactose.
• Lactose-free dairy products, such as lactose-free milk, cheese, and yoghurt.
• Plant-based milk alternatives, such as almond, soy, or oat milk.
• Some individuals tolerate small amounts of lactose without symptoms. Gradually introducing dairy into your diet may help you identify your tolerance level. Also, including a little lactose in your diet can encourage the growth of gut bacteria that help to breakdown lactose.
• Consult a nutritionist or dietitian to help you create a lactose-free diet plan to ensure you receive essential nutrients like calcium and vitamin D.
Lactose intolerance is a common condition that affects many individuals. Recognizing the symptoms and adopting suitable management strategies are essential to maintain a healthy and comfortable lifestyle. With proper management, most people with lactose intolerance can continue to enjoy a wide range of foods while minimizing discomfort.