Lactose Intolerance- symptoms, diagnosis & treatment
Lactose and lactose intolerance- an overview
- Lactose is a sugar that occurs naturally in milk and other dairy products.
- It’s digested by an enzyme in your gut called lactase, which breaks it down to simpler sugars.
- If you haven’t got enough of the lactase enzyme, you can’t digest lactose properly, and you get Lactose Intolerance – with symptoms such as bloating, burping, diarrhoea, abdominal pain and irritation of the skin around the anus.
- In babies, Lactose Intolerance cause poor weight gain.
- It’s important to realise that Lactose Intolerance is NOT an allergy. It’s simply the inability to digest lactose.
Types of Lactose Intolerance
- Lactose Intolerance can be inherited from your parents. Some people are born without any lactase enzyme whatsoever. This is called congenital lactase deficiency. This tends to cause symptoms from birth, as both breast milk and formula contain lactose.
- Primary lactase deficiency is a little less severe- in this condition, there is some lactase, but levels are low-it can become symptomatic at any age, though it’s rare before the age of 6.
- It’s also possible to develop lactose intolerance if your gut becomes temporarily inflamed for some reason- for example, after a bout of gastroenteritis. This type of Lactose Intolerance tends to settle whenever the inflammation o underlying condition gets better.
- Developmental lactase deficiency may occur in premature babies because their gut has not yet matured. It settles as they get older.
What about cow’s milk protein allergy?
- Some people DO have an allergy to cow’s milk protein- this is an entirely different condition to Lactose Intolerance, though it may cause similar symptoms.
- In fact, cow’s milk protein allergy is more common cause of milk intolerance in babies than Lactose Intolerance.
- Most children grow out of this allergy
Diagnosis of Lactose Intolerance
- Diagnosis may be made based on presence of symptoms of Lactose Intolerance
- It may be confirmed if lactose is withdrawn from the diet and symptoms settle.
- It’s also possible to perform a test on a stool (poo) sample, or your doctor may recommend a special lactose breath test, to confirm the diagnosis.
Treatment of Lactose Intolerance
- The treatment for Lactose Intolerance is to reduce the amount of lactose in the diet, or eliminate it entirely if necessary.
- Obviously, in small babies and children with lactose intolerance, treatment should be supervised by a GP, paediatrician and/or dietitian- particularly if there are concerns about poor weight gain or other symptoms of Lactose Intolerance.
- Some people who are lactose intolerant will still be able to manage small amounts of lactose- though it may take a while to figure out personal limitations. A study in 2010 showed that most people with Lactose Intolerance could tolerate a glass of milk a day without any problems.
- Some dairy products are less problematic than others- for example, hard cheeses like Cheddar, Parmesan and Emmenthal are naturally lower in lactose.
- Also, dairy products with thicker consistency, such as natural yoghurt, may be better tolerated than milk, as they are digested more slowly.
- It’s wise to check food labels for hidden lactose.
- Some people take lactase (enzyme) tablets when they are eating lactose- these supplements are available in health food stores. It’s not clear how effective they are- more research is needed.
- In the case of temporary Lactose Intolerance after an episode of gastro, often no changes are recommended, as the symptoms will settle down quite quickly anyway.
Other important advice about Lactose Intolerance
- If you have been diagnosed as lactose intolerant or have symptoms of Lactose Intolerance, and are therefore avoiding dairy products, it’s important to source adequate amounts of calcium from other foods to protect bone health.
- If you have been told you might have Lactose Intolerance but you are not feeling 100% sure of the diagnosis, it’s best to speak to a doctor and consider proper testing.
- You can also read more about lactose intolerance in children on the Royal Children’s Hospital Website
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Clinical review & governance
Medically reviewed by Dr AIFRIC BOYLAN
CEO
About Dr Aifric Boylan MB BCh BAO MICGP FRACGP DRCOG DCH Fellow of the Royal Australian College of General Practitioners, Dr Aifric Boylan is a general practitioner with more than 20 years' experience. She graduated in medicine from…
This health information has been clinically reviewed by an Australian doctor. Qoctor health pages are reviewed to support clear, evidence-informed guidance; they do not replace individual medical advice.
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