Jokes about lactose intolerance have become common online and in the media. We’ve all heard the punch line about the lactose intolerant person stubbornly eating ice cream, right? But the fact of the matter is that many people who may be lactose intolerant may not realize it because symptoms are inconsistent or minor. So, how do you know if you have this intolerance? At Batash Medical in New York, NY, we know there are a few signs to look out for – and a couple of things you can do to work around that intolerance.
But first, let’s go over what lactose intolerance is. Lactose is sugar that is commonly found in mammalian milk, such as milk from cows. People who are lactose intolerant do not produce enough lactase, an enzyme in the body that breaks down lactose, which means that they are unable to digest the lactose. This leads to some pretty uncomfortable gastrointestinal upsets, which is the main indicator of lactose intolerance.
How Do You Know If You Have a Lactose Intolerance?
The simplest way to determine if you are lactose intolerant is to pay attention to your symptoms – particularly when symptoms happen after you eat dairy or drink milk. Many of the signs of lactose intolerance occur in the gastrointestinal tract, typically within hours of ingesting a product containing lactose. Many people can self-diagnose this type of intolerance and make changes in their diet. The most common symptoms include:
- Stomach Cramps and Bloating
- Because your body is unable to digest and break down lactose, the bacteria in your gut reaction to the lactose by fermenting the sugar. This process creates gasses like hydrogen, methane, and carbon dioxide, as well as increases fatty acids that are associated with stomach pain, cramps in the gut, and even bloating. Sometimes the bloating and cramps are intense enough to cause nausea and vomiting.
- The amount of lactose you ingest does not correlate directly with the amount of discomfort you will experience with cramps and bloating. Rather, your specific sensitivity will determine how uncomfortable your symptoms will be. Some people may be able to tolerate an entire glass of milk, while others won’t even be able to tolerate a spoonful of ice cream or other milk-based dairy products.
- Diarrhea or Constipation
- Another common symptom of this intolerance is toileting frequency – some people have diarrhea and some people become constipated based on how your individual biology responds to the lactose in your body. Diarrhea caused by lactose happens because of the increase of water in the colon and the acids that are released into the colon during the end stages of digestion. Of course, diarrhea is also caused by malabsorption and inflammatory bowel disease, so this is not a fool-proof sign to watch out for.
- Constipation related to this type of intolerance is thought to be caused by the increased methane gas that is produced when the lactose sugar is fermented by bacteria in the gut. As methane slows down the digestion process, you may become constipated. That said, constipation is not the most common symptom of this intolerance. People are much more likely to have diarrhea.
- Increased Flatulence
- The final most common symptom of this intolerance is increased gas or flatulence. The fermentation of lactose sugar in the colon increases gas in the body that must be expelled. Usually, this gas is odorless and may or may not come before other gastrointestinal upsets. The amount of gas produced in your colon may also be related to the sensitivity you have to lactose sugar.
Is Intolerance the Same as an Allergy?
Many people mistakenly believe that people who are lactose intolerant are allergic to milk or other dairy products, but this simply isn’t true. A milk allergy is like any other food allergy, and although intolerance and milk allergies do sometimes occur together, this isn’t always a rule. Milk allergy symptoms may include rashes, hives, eczema, stomach pain, vomiting, and anaphylaxis. The only way to determine if you have a milk allergy is to be formally tested.
How Do You Diagnose Intolerance?
The main way to formally diagnose intolerance to lactose is with a hydrogen breath test. This test will take about two hours. For this test, you will be asked to drink a beverage containing lactose; about fifteen minutes after consumption, you will blow into bags every 15 minutes for two hours. These bags will be tested for the presence of hydrogen and other gases that may be produced when lactose begins fermentation in the gut. If your breath has elevated hydrogen levels, you are most likely lactose intolerant.
- How Should You Prepare for This Test?
- You will need to be prepared for a long appointment when you take a hydrogen breath test. You should tell your physician if you are pregnant or if you have lung or heart diseases before you start this test. Please do not consume any foods or beverages, including water, for at least 12 hours before your test begins. You should also avoid taking antibiotics for at least two to four weeks before the test. We may give you additional instructions to help you prepare.
- What Should You Do After Your Test?
- You will likely have some gastrointestinal discomfort during or after your test, so be sure to be prepared to take the rest of the day off. Provided you are not suffering from symptoms of intolerance, you should be able to return to your daily activities. The results of your test may be immediate or may take a few days.
How Can You Manage Symptoms?
The very best way to manage intolerance to lactose is by avoiding foods that are high in lactose. In general, that means limiting how much lactose you eat or studying which food containing lactose causes the most discomfort. It’s common for people to stop drinking cow milk but continue to eat cottage cheese, ice cream, cheese, and sour cream without any issues.
- Milk Substitutes
- Milk is often an essential part of a daily diet. After all, dairy products are where most of us source our calcium for bone health. However, there are several milk substitutes to consider. For example, lactose-free milk has been processed to remove the lactose sugar from the milk. This milk typically has additives like calcium, protein, and vitamins.
- You may also consider soy milk, rice milk, almond milk, coconut milk, or oat milk. These milk alternatives have a slightly different taste compared to cow milk but can generally be used in the same way. Non-dairy milk alternatives may contain additional nutrients that can support a healthy diet.
- Pay Attention to Your Calcium Intake
- If you are cutting milk and other dairy products out of your diet, then you will need to be sure that you are getting enough calcium through your food. Ideally, any calcium supplement you take should be combined with vitamin D for increased absorption. Calcium-rich foods include leafy greens, cruciferous vegetables, and some seafood. Calcium is an essential nutrient for your body, particularly as you age.
What Causes Intolerance?
This type of tolerance happens as a result of your body not producing a high enough level of lactase to break down the lactose sugar found in dairy products. Our bodies produce a very high level of lactase from infancy through childhood, but as we reach adulthood, we produce a much lower amount. This is why it often seems that intolerance happens suddenly or inconsistently as you get older.
How Common Is This Intolerance?
This type of intolerance is much more common than many people believe. An estimated 65% to 70% of the global population is intolerant to lactose sugar. In America, roughly 30 to 50 million people have this intolerance. This type of intolerance is most common in African Americans, Native Americans, and Asian Americans, although people of Northern European descent may also develop an intolerance.
Test For Lactose Intolerance Today
Most people will be able to know whether or not they are lactose intolerant by studying their symptoms, but sometimes a hydrogen breath test can have a more conclusive result. You may be a good candidate for this test if you have gastrointestinal discomfort after consuming products that are high in lactose sugar. By altering your diet, you can easily manage intolerance and live more comfortably. Contact Batash Medica in New York, NY to learn more about lactose intolerance today.