Lactose intolerance is gastrointestinal upset due to the inability to digest significant quantities of lactose. Lactose is a sugar found in milk and other dairy products.
Lactose intolerance is caused by a reduction in the digestive enzyme lactase. Lactase breaks down the sugar lactose into sugars that can be more easily absorbed. When not fully broken down, lactose ferments in the colon and causes symptoms.
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Some people are born unable to make lactase. Others develop the intolerance over time.
Factors that increase your risk of lactose intolerance include:
Symptoms of lactose intolerance generally begin within two hours of consuming milk or other dairy products. The severity of symptoms depends on how much lactase your body produces and how much lactose you eat.
The doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor may recommend a trial period of eating no milk or milk products to see if symptoms resolve.
Your doctor may want to perform tests to help make the diagnosis. These may include:
Your doctor may recommend a biopsy to examine small intestine tissue.
Treatment focuses on managing symptoms. For most people, removing dietary lactose, especially in children and adolescents, would not be recommended. Milk and milk products provide sources of calcium and other food elements that are hard to replace. If complete elimination is chosen, then careful replacement of calcium is needed for good health.
Keep a food diary of what you eat and what the reaction is. Discuss the findings with your doctor or a dietitian.
Dietary changes may include:
Your doctor may recommend lactase enzymes if you can tolerate only small quantities of lactose. The enzyme supplements come in liquid and chewable form. A few drops of the liquid added to milk, which is allowed to sit overnight, can decrease the amount of lactose in the milk. Tablets are chewed or swallowed before eating foods that contain lactose.
Last reviewed June 2013 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.