Do you love ice cream, cheese, milk and other dairy products, but know that they don’t love you back? If these foods cause bloating, diarrhea, cramping and gas, you may be lactose intolerant.
You are not alone—at least 36 percent of Americans have trouble digesting lactose, and the number is probably higher.
How the Body Digests Lactose
Lactose is a type of sugar found in dairy products. When you eat foods containing lactose, a digestive enzyme in your small intestine called lactase breaks down the lactose so the body can absorb it, along with other nutrients from digested food. If the body doesn’t produce enough lactase, the food containing lactose moves on to the large intestine (colon), and bacteria that live there try to digest it, creating gas, cramping, diarrhea and discomfort.
The result can be painful, distressing and often embarrassing, says UNC Health gastroenterologist Silpa Yalamanchili, MD.
Some people who are lactose intolerant can drink small amounts of milk or occasionally eat cheese or yogurt. Every person reacts differently, Dr. Yalamanchili says.
“It’s not dangerous in the sense that there is no long-term harm” from eating dairy, Dr. Yalamanchili says. “But the symptoms can be bothersome.”
The Onset of Lactose Intolerance
Some people are born with the disorder, which can be genetic, Dr. Yalamanchili says. They may start having symptoms as infants, children, teens or young adults. But people of all ages—even seniors—can develop lactose intolerance, sometimes after a digestive tract infection, injury or other condition, she says.
One sign that a baby or toddler is lactose intolerant is if they are struggling to gain weight. Babies who are lactose intolerant might even have trouble digesting breast milk. A pediatrician may recommend an infant formula that doesn’t contain lactose, usually a soy-based formula.
Lactose intolerance also can develop after a child or adult gets a gastrointestinal infection with certain bacteria.
Some ethnic groups have higher rates of lactose intolerance than others; in the United States, Black, Latino and Asian people, as well as American Indians, are more likely to be lactose intolerant.
Lactose intolerance is not the same as a milk allergy, which can be much more severe and even life-threatening. Your doctor can help you determine which condition you or your child may have.
How to Know if You or Your Child Is Lactose Intolerant
A doctor can give you a test to measure how much hydrogen is in your breath; if you have trouble digesting lactose, your breath will have higher amounts of hydrogen. The test involves drinking milk or a lactose-containing syrup and blowing into a machine. Not all physicians have the equipment to do this test, though.
Of course, there is another highly reliable way to diagnose the condition, Dr. Yalamanchili says. “Just eliminate lactose for two weeks and see if you feel better.”
Lactose is found in dairy products, and some nondairy items, too.
“Check the labels,” she says. “A lot of products contain lactose, including bread and other baked goods, processed breakfast cereals, pancake mixes, non-kosher lunchmeats and candy, especially chocolate. You may want to talk to a dietitian who can help you avoid problems.”
Treating Lactose Intolerance
You can try over-the-counter products that supplement lactase in your body and make it easier to process lactose, Dr. Yalamanchili says.
If you want to avoid lactose, a dietitian can help you find other sources of calcium and vitamin D, which are critical for good nutrition. Your body needs calcium to keep your bones and teeth strong, and to help your muscles and nerves work well. Vitamin D helps the body absorb calcium and reduces inflammation, among other important functions.
Milk is available that is made from soy, rice, almonds, oats, coconuts, hemp and other plants, often enriched with calcium and vitamin D. Beware of any dairy products from animals, including goats, because they contain lactose. A wide variety of dairy-free cheese, yogurt and ice cream also are available.
You can find calcium in nondairy products as well, including spinach, kale, almonds, broccoli, figs, sunflower seeds, sweet potatoes and sardines. Vitamin D can be boosted with brief periods of sun exposure, by eating fatty fish or by taking a dietary supplement.
If you are concerned about symptoms such as bloating, diarrhea, abdominal pain and gas, talk to your doctor, or find one near you.