What Is Lactose Intolerance?

You are lactose intolerant when you can't digest lactose, a milk sugar.  To digest this sugar, your body needs an enzyme called lactase.  If your body doesn't have enough lactase, it can't digest the lactose in the food you eat and drink.

What Causes Lactose Intolerance?

Lactase is normally made by the cells in the small intestine.  Some people are born without enough lactase.  Most people with lactose intolerance, though, are born with the enzyme, but later lose it. This can happen normally during the aging process.  It also may sometimes happen if a person goes a long time without eating or drinking dairy products.  Certain ethnic groups, including African Americans, Native Americans, and Asians, are more likely to lose lactase as they age.

What Causes the Symptoms?

If the intestines don't make enough lactase, lactose does not get broken down.  Undigested lactose can cause bloating, cramping, gas and stomach rumbling.  When undigested lactose travels into the colon, it carriers water with it.  Extra water in the colon can lead to diarrhea.

Understanding Lactose Intolerance

If you are lactose intolerant, you can't digest lactose, a sugar found in milk and other dairy products.  Many people are lactose intolerant.  Undigested lactose won't hurt you, but it can cause unpleasant symptoms.  The good news is that you can get relief.

 

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Common Symptoms

If you are lactose intolerant, you may notice the following symptoms about an hour or more after eating or drinking dairy products:

  • Gas or bloating

  • Abdominal cramps and pain

  • Rumbling stomach

  • Diarrhea

Confirming the Problem

Some tests can confirm lactose intolerance and rule out other problems that may be causing your symptoms.  Tests may include a lactose tolerance test, breath test, stool test, or blood test.  Ask your doctor about them.

What You Can Do

To help reduce your symptoms, look for ways to limit the amount of lactose you eat.

Finding Your Limit

People with lactose intolerance may think they can't eat or drink any dairy products.  This is often not true.   Many people with lactose intolerance can eat or drink small amounts of dairy products without symptoms.  To find your own limit, keep track of what you eat and drink.  Write down when you have symptoms.  Learn how much and what kinds of dairy products you can handle.

Tips to Reduce Symptoms

  • Choose low-lactose diary products.   These include buttermilk and aged cheeses (such as cheddar)

  • Eat foods with active cultures, such as yogurt.  Active cultures make lactose easier to digest.

  • Eat or drink diary products with other foods to lessen symptoms.

  • Substitute fruit juice for some or all of the milk in recipes.

  • Take lactase enzyme tablets with diary products to help reduce symptoms.

  • Avoid eating many high-lactose foods (such as milk, cream, butter and ice cream) at one time.

 

Try Nondairy Substitutes

If a food on the "dairy" list following bothers you, try a substitute listed to the right.
Dairy Substitute
Milk, cream Soy drink, rice drink, nondairy creamer, lactose reduced milk
Cheese Tofu (soy) cheese, some aged cheese
Butter, margarine Vegetable oil, milk free margarine
Creamy Salad Dressings Vinegar-based dressings
Ice cream Fruit sorbet, juice bars

Eat Other Calcium-rich Foods

Dairy products are an important source of vitamins and minerals, especially calcium.  If you eat less dairy, you may be getting less calcium.  Ask your doctor about calcium supplements.  Also, eat more dairy-free calcium rich foods such as:

  • Broccoli, kale, bok choy, turnip greens

  • Fish with edible bones

  • Alfalfa sprouts, soy sprouts

  • Tofu, soybeans, pinto beans, navy beans

  • Almonds, sesame seeds, hazelnuts

  • Calcium-fortified orange juice, soy drink, rice drink

  • Molasses

Look for Hidden Lactose

If you are sensitive to small amounts of lactose, you may need to avoid any product that contains lactose.  Some medications are made with lactose, so ask your pharmacist to suggest substitutes.  Many baked goods, cold cuts, and other packaged foods also contain lactose.  Read food labels.  Avoid ingredients like milk, milk solids, whey and curds.