Do you also get stomach problems when you drink milk? This is about lactose intolerance!

It's a common experience for many of us to feel some discomfort in our stomach after drinking some milk, or after eating a dairy product like yogurt or ice cream. Some people feel full, have a gurgling sound, others have stomach pain, or even flatulence. Have you ever had any of these things? Then we're going to talk about something that could be very important to you. That's a condition called lactose intolerance .

What is Lactose Intolerance?

Simply put, lactose intolerance is a condition that occurs when our digestive system is unable to properly digest lactose, a sugar found in milk and dairy products. Many people have difficulty digesting this lactose, but not everyone experiences major symptoms. But if you experience discomfort when you eat dairy products, that's what we call lactose intolerance.

Now you may be asking, what is lactose malabsorption? It is a condition in which our body is unable to absorb the nutrients contained in lactose molecules. This is actually very common. About 65% of adults in the world cannot digest lactose properly. It is when this undigested lactose passes through our digestive system that some people experience the aforementioned discomfort.

What is the difference between lactose malabsorption and lactose intolerance?

This may seem a bit confusing, but it's simple. Not everyone with lactose intolerance has lactose malabsorption . But not everyone with lactose malabsorption has symptoms of lactose intolerance .

Think of it this way, lactose malabsorption occurs in our small intestine . That is, lactose is not properly absorbed by the body in the small intestine. However, the symptoms (those stomach discomforts) that occur as a result occur later, that is, in the large intestine .

Our small intestine is where we absorb most of the nutrients from the food we eat. The small intestine breaks these nutrients down into smaller particles and passes them through the intestinal walls into the bloodstream. The unabsorbed food passes into the large intestine.

Now, when the undigested sugar particles (in this case lactose) reach the large intestine, the amount of water increases there, and gas also increases. To help expel these undigested sugar particles, the large intestine secretes more fluid. Also, when the bacteria in the large intestine ferment these sugars, gas is produced. That's what causes bloating, flatulence, and stomach pain.

How many symptoms you have depends on a few other things. For example, can you digest some lactose or not at all? How much lactose do you eat at a time? Do you have other medical conditions that affect the amount of water and air in your colon? These are the things a doctor will ask you.

What are the symptoms?

A person with lactose intolerance may experience symptoms such as:

• Bloated stomach: A feeling as if the stomach is full of air.
• Intestinal gas: Frequent passing of air.
• Nausea and vomiting: Some people feel like vomiting, and some may even vomit.
• Stomach pain and cramping: A pain that feels like the stomach is being squeezed from the inside.
• Stomach gurgling or rumbling: A sound coming from inside the stomach.
• Diarrhea: The passage of liquid stools.

These symptoms occur when undigested lactose moves into your large intestine. It takes about six to ten hours for food to travel to your large intestine after we eat it. It then takes another 24 to 36 hours to travel through your large intestine. This means that you can experience symptoms even a day or two after eating something that contains lactose.

What foods cause symptoms of lactose intolerance?

Most milk and dairy products contain lactose, unless they have been defatted. Cow's milk and goat's milk contain this. Some dairy products have more lactose, while others have less. For example, fresh milk and cream have more lactose, while hard cheeses have less lactose. Sometimes you can add a little cheese to a salad.

On the other hand, if you are very sensitive to lactose, even small amounts can cause symptoms. So when buying foods, check the ingredient lists on the labels. Sometimes lactose is added to processed foods that we don't even think about. For example, in soups, salad dressings, snack foods, etc. There are times when lactose is added to some medications.

What are the causes of lactose intolerance?

There are two main causes of this: lactose malabsorption ( the inability to properly absorb lactose) and gut sensitivity . The most important of these is lactose malabsorption. When lactose is not properly broken down and absorbed in the small intestine, the lactose moves into the large intestine and causes the symptoms.

Lactase enzyme deficiency

Our small intestine needs a special enzyme to break down the sugar lactose into small particles that the body can absorb. It's called lactase.When we are young, that is, when we are breastfeeding, this lactase enzyme is well-developed in our small intestine. It is what helps us digest breast milk. However, as we grow older, the production of this lactase enzyme in most people's bodies decreases.

If you don't have enough lactase, you won't be able to digest lactose. Some people have more of this enzyme, while others have less. But in reality, the majority of people in the world have lactose malabsorption due to a lack of this enzyme. Only certain groups of people develop lactase well into adulthood.

You and the nature of your intestines

This is where your gut sensitivity comes in. We all eat things that we can't digest properly sometimes. Some dietary fibers and sugars pass through our digestive tract and become food for the bacteria in our gut. For most of us, these little things don't cause major symptoms.

But everyone is a little different. Our genes, gut health, sensitivities, and diet all play a role. The mix of bacteria in your gut (also called your gut microbiome ) can be different from someone else's. So, your symptoms will tell you how much lactose you can tolerate.

What are the four types of lactose intolerance?

There are four main types of this condition, along with their causes:

• Primary: This is the most common type. It is caused by a gradual decrease in the production of the lactase enzyme in the small intestine.
• Secondary: Occurs when the small intestine is damaged by another disorder, injury, or disease. For example, some surgeries, infections, or conditions like Celiac disease .
• Congenital: This is very rare. It is caused by a lack of the lactase enzyme at birth.
• Developmental: It occurs in premature births because the small intestine is not fully developed.

Is lactose intolerance genetic?

Yes, genes play a role in this to some extent. Your genes determine how long your body produces the enzyme lactase. They can also affect your gut sensitivity and the types of bacteria in your gut. Some bacteria convert lactose into gas, but others convert lactose into lactic acid. This lactic acid buildup may not cause symptoms.

You are more likely to develop lactose malabsorption and lactose intolerance if your genetic profile is as follows:

• Asian
• Native American
• Hispanic

If your genetic profile is like this, you are more likely to continue to produce lactase and tolerate lactose:

• Northern European
• African
• Middle East

Very rarely, some people are born with congenital lactase deficiency . This is a genetic condition that causes lactose intolerance from birth.

Can lactose intolerance develop over time?

Many people develop lactose intolerance from childhood to adulthood. The most common type , primary lactose intolerance, which we discussed earlier, develops as your body gradually reduces its production of the enzyme lactase. Also, your gut sensitivity can change over time.

In addition to lactose malabsorption, you are more likely to experience symptoms if you have any of the following conditions:

• Irritable Bowel Syndrome (IBS)
• Visceral hypersensitivity (intestinal hypersensitivity)
• Small intestinal bacterial overgrowth (SIBO)

These conditions usually develop gradually over time.

Is it possible to suddenly develop lactose intolerance without any prior history?

Yes, secondary lactose intolerance can develop suddenly due to damage to your small intestine. Injury, surgery, infection, or long-term illness can damage the cells that make lactase. This can cause lactose malabsorption and intolerance, even if you were previously able to digest lactose.

There are several possible causes of secondary lactose intolerance:

• Radiation therapy
• Small bowel resection
• Cystic fibrosis
• Inflammatory bowel disease (IBD) (e.g. Crohn's disease, ulcerative colitis)
• Celiac disease
• Enterocolitis ( an infection and inflammation of the intestines)

However, this secondary lactose intolerance is not always permanent. Once your small intestine functions properly, you may regain the ability to digest lactose.

How do you know if you have lactose intolerance?

If you continue to experience the same stomach discomfort as mentioned above after eating dairy, you may suspect that you have lactose intolerance. However, many people with low levels of the enzyme lactase can tolerate some amounts of lactose at times. So, if you are not sure if lactose is really causing your discomfort,The best thing is to find a doctor.

What are the tests for lactose intolerance?

Doctors have several tests to confirm this condition. The most common tests are:

• Hydrogen breath test: This measures the amount of hydrogen and methane gas in your breath. This gas is produced by bacteria in your large intestine. If you have high levels of gas shortly after drinking a liquid containing lactose, it means that bacteria in your intestine are fermenting the lactose and producing gas.
• Blood glucose test: If the breath test is inconclusive, your doctor may order this blood test. This test measures your blood sugar levels before and after you drink lactose. If your blood sugar levels are not high, it means you haven't digested the lactose.
• Stool acidity test: This test is often used on young children and infants. After giving the child lactose, a stool sample is taken and analyzed. The levels of lactic acid and other byproducts in the stool can be used to determine whether the body is absorbing the lactose.

What are the treatments for lactose intolerance?

To digest lactose, you need to have the enzyme lactase in your intestines. Many people with lactose intolerance cannot make lactase naturally. However, you can give your body the lactase enzyme it needs by taking lactase supplements . These can be taken in the form of tablets or drops before eating a food that contains lactose.

Researchers are also testing a type of bacteria called lactic acid bacteria as a treatment for symptoms of lactose intolerance. These bacteria convert lactose into lactic acid instead of air. Taking these bacteria as probiotics , and taking prebiotics, which provide food for them, has been found to increase lactose tolerance.

How to manage lactose intolerance through diet?

Experiment with your diet to find your personal lactose threshold. Some people are fine with some dairy foods, in certain amounts, or with other foods. Start with a lactose-free diet, then gradually add lactose-containing foods to see how your body responds.

Some people with lactose intolerance can tolerate about 12 grams of lactose at a time. That's about the same as a cup of milk or a scoop of ice cream. Also, many dairy products in supermarkets now have lactose-reduced andLactose-free varieties are available. Consider adding these and other dairy alternatives to your diet.

Can lactose intolerance be completely cured?

Secondary lactose intolerance , which is caused by damage to the small intestine, may improve after the damage has healed. It depends on how permanent the damage is. It can take some time. Developmental lactose intolerance, which is caused by premature birth, usually goes away as babies get older.

However, if you have primary or congenital lactose intolerance, your body will not naturally produce more lactase. However, if your gut health or gut microbiome changes, your symptoms may change. You may be able to tolerate a little more, or experience a little less symptoms.

What happens if lactose intolerance is ignored?

Lactose intolerance won't cause you any serious harm. If you can tolerate the symptoms until the lactose passes through your digestive system, they will go away after a while. However, you can easily avoid these uncomfortable symptoms by using lactase supplements and lactose-free dairy products.

Are there any long-term effects of lactose intolerance?

Lactose intolerance affects your diet, so you need to be careful about the nutrients you consume. If you cut out all dairy products, you may become deficient in calcium and vitamin D. Although you can get these nutrients from other food sources, dairy products are the most common source.

Calcium deficiency or vitamin D deficiency can affect your bones, muscles, and nervous system. These deficiencies can especially affect growing children. If you can't get enough of these from food, a doctor may recommend taking calcium or vitamin D supplements.

Is lactose intolerance an allergy?

No. A food allergy is a reaction of your immune system , usually to a protein in the food you eat. Your immune system recognizes that protein as a threat and reacts to get rid of it. If you have an allergy, even a small amount of the protein can cause a big reaction, and it usually happens shortly after eating the food.

An allergic reaction can cause symptoms not only in your digestive system, but throughout your body. You may experience things like swelling, hives, and difficulty breathing. You may also experience stomach pain, nausea, and vomiting, but this usually happens early in the digestive process, when the protein is in the stomach.

The difference between lactose intolerance and milk allergy

The main difference is that a milk allergy is a reaction of your immune system to a milk protein. Lactose intolerance is a reaction of your digestive system to a sugar (lactose) in milk. An allergic reaction is a sudden, severe reaction. It can be immediate, severe, and sometimes life-threatening (called anaphylaxis ).

When your digestive system reacts to an indigestible sugar, it can cause uncomfortable symptoms during the digestive process, but it's not dangerous. The undigested lactose causes extra water and gas to build up in your colon. You may feel bloated and gassy until it passes, but it won't harm you.

The difference between lactose intolerance and milk protein intolerance

Like lactose intolerance, milk protein intolerance begins with malabsorption in the small intestine. When your small intestine is unable to break down and absorb a protein in milk (usually casein or whey ), the undigested protein passes through your intestines, along with undigested sugars.

The difference is, undigested proteins in your digestive tract can send an alert to your immune system. Later in the digestive process, your immune system can recognize that protein as an allergen and mount a delayed immune response. You can even develop an allergy to that protein later on.

Lactose intolerance is not a disease. It is just a natural variation in the way our digestive systems work. In fact, the ability to digest lactose after infancy is a relatively new genetic adaptation in humans. Not all of us have that adaptation, and that is not a problem. You can live a healthy life with lactose intolerance.

If you have digestive problems that you think are related to dairy products, a doctor can help you. He or she can test you for lactose intolerance and other causes of your symptoms. If you have lactose intolerance, a doctor can also help you make lifestyle changes to help you manage your symptoms.

Finally, things to remember (Take-Home Message)

• Many people experience stomach discomfort when consuming milk or dairy products, which is called lactose intolerance .
• The main reason for this is the decrease in the enzyme lactase in the body.
• Symptoms are not the same for everyone, and it is important to find the amount of lactose you can tolerate.
• Lactase supplements and lactose-free products can be used.
• This is not an allergy, but since dairy foods are restricted, be careful about calcium and vitamin D.
• If you have any doubts about this, it's best to seek medical advice. There's nothing to worry about, this is a manageable condition!

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