The 411 on Lactose Intolerance

When someone says, “I can’t have dairy,” we automatically assume they are lactose-intolerant or that they are allergic to dairy, and that is as far as our knowledge goes with this condition. “Lactose” actually means “sugar.” This type of sugar is specifically found in dairy products.

There is an enzyme that our body produces in the small intestine, called lactase (not lactOse, but lactAse). However, when a person is lactase deficient, symptoms can arise once they eat dairy. Many people who have a low level of lactase are still fine eating dairy, but for others who have true intolerance, symptoms can include gas, bloating, diarrhea, abdominal cramps, and sometimes vomiting.

When the body has an adequate amount of the lactase enzyme, it turns the lactose sugar into glucose and galactose. When there is a deficiency of the lactase enzyme, the food consumed moves to the colon instead of undergoing digestion and absorption. Then bacteria in the colon forms, causing the symptoms of lactose intolerance.

There are a few risk factors: Asian, African, American Indian, and Hispanic people find this condition to be more common among their race. Premature babies are at risk because their small intestines may not have fully developed. Having any problems or disease associated with the small intestine raises the risk for someone.

There are three main types of lactose intolerance:

1. Primary: This is the most common type that develops in adulthood. Milk products become hard to digest and genetics are usually the key determinant.
2. Secondary: This type occurs as the result of an injury, illness, or surgery that affected the small intestine. The small intestine has started to produce less lactase. This is the type of condition that is associated with Celiac and Chron’s disease.
3. Congenital or developmental: This would arise if the mother and father have both passed on the gene to their child. It is rare to be lactose intolerant during infancy.

A doctor can diagnose this condition by having a person perform the lactose intolerance test which involves drinking a liquid that monitors the body’s reaction to lactose. There is also the hydrogen breath test where a doctor has the person consume a beverage high in lactose, then measures the amount of hydrogen in the breath. If the body doesn’t like lactose, it will release those gases and hydrogen during this test. A stool sample can also be taken. Through trial and error, a person can determine if they need to completely avoid dairy, discover what items to particularly avoid and those that are safe foods, and can use lactose-free or lactose-reduced products. We have to eat to live but we were not all given the same digestive tract for this process. Milk does a body good, but not when the body rejects its digestion.

Sources:

https://www.mayoclinic.org/diseases-conditions/lactose-intolerance/symptoms-causes/syc-20374232 

https://www.hopkinsmedicine.org/healthlibrary/conditions/digestive_disorders/lactose_intolerance_85,P00388 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3401057/

https://www.ncbi.nlm.nih.gov/pubmed/24443063