What is Lactose Intolerance?
Lactose is a milk sugar. Lactose intolerance is the reduced ability to digest milk sugars, due to insufficient amounts of the gut enzyme called lactase.
Lactose is normally broken down by lactase in the small intestine and ends up in the bloodstream as glucose. People with lactose intolerance don’t have enough of this enzyme to properly digest lactose, resulting in undigested lactose making it’s way to the large intestine and cause digestive upset in many people. Common symptoms are:
Diarrhoea
Stomach cramps
Bloating
Excessive flatulence
Lactose intolerance is commonly grouped into two main subtypes:
Primary (also referred to as congenital)
A rare genetic condition where a baby is born without any lactase enzymes at all. This means they are unable to digest or absorb lactose.
Babies with this condition fail to thrive from birth, and have severe diarrhoea from the day they are born.
Diagnosis usually occurs straight after birth and babies with this condition must completely avoid lactose.
This would involve the baby not being able to breastfed as lactose is still a component of breast milk, even if the mother completely excludes dairy from her diet.
Secondary
This is the most common form of lactose intolerance.
Occurs with age as the gut produces less lactase with age.
Occurs when the gut lining (where lactase is produced) is damaged. This can happen due to a gastroenteritis, intestinal infections (bacteria, parasite, yeast, SIBO), stress, toxins, a processed diet or due to chronic irritation (such as that due to food allergy or food intolerance).
What is the Difference Between Lactose Intolerance and a Dairy Allergy?
Lactose intolerance and dairy allergies are commonly confused. Though they may share similar symptoms which occur after consuming milk or dairy products, they are in fact different conditions.
Lactose intolerance is a problem with the digestive system, while a dairy allergy is a problem with the immune system.
Lactose intolerance may cause pain and discomfort but is not dangerous, whereas an allergy can have far more serious consequences.
Managing Lactose Intolerance
Most people with lactose intolerance can generally handle small amounts spread across the day. Not all dairy products contain high amounts of lactose, butter, ghee, hard cheeses and natural yoghurt tend to be tolerated in small amounts.
Follow the guidelines below and begin to trial your own lactose tolerance. I would recommend completely removing it from your diet initially, and then trying to include small amounts of low-lactose foods and closely monitoring your symptoms. If you feel better without any lactose at a;; in your diet, it is best to avoid it as much as possible to reduce gastrointestinal stress.
Other Things to Consider:
→ Look out for hidden lactose (added ingredients, preservatives, medications etc).
→ Be conscious of your calcium status and ensure you are getting adequate amounts from non-milk sources.
→ Watch out for unnecessary extra ingredients commonly found in dairy and lactose free alternatives (gums, sweeteners, preservatives, vegetable oils etc).
→ Consider a digestive enzyme with meals: Digestive enzymes containing lactase to help improve the digestion of milk and other dairy products. Lactase enzymes won’t make it okay for you to drink milk to your hearts content, but it may be beneficial when consuming small amounts of lactose.
Diagnosis of Lactose Intolerance
Hydrogen Breath Test
Elimination Diet
