Lactose Intolerance

What Is Lactose Intolerance?

Lactose intolerance is a common digestive problem that happens when your body can’t fully digest lactose, the natural sugar found in milk and other dairy products. People with this condition don’t make enough of an enzyme called lactase, which helps break down lactose in the small intestine.

When lactose isn’t broken down properly, it travels to the large intestine where it ferments — causing gas, bloating and discomfort. While it’s not dangerous, lactose intolerance can be very uncomfortable and affect your quality of life.

This condition affects millions of people worldwide. It’s more common in adults and in certain ethnic groups, including African American, Asian, Hispanic and Native American populations.

What Causes Lactose Intolerance?

There are a few types of lactose intolerance, and each has different causes:

• Primary lactose intolerance – This is the most common type and is genetic. The body slows lactase production with age, especially after childhood.
• Secondary lactose intolerance – This happens after an illness, injury or surgery that affects your small intestine, such as Crohn’s disease, celiac disease or infections.
• Congenital lactose intolerance – A rare condition where babies are born without any lactase enzyme.

Symptoms of Lactose Intolerance

The most common lactose intolerance symptoms include:

• Bloating
• Gas
• Diarrhea
• Stomach cramps
• Nausea
  
  

Symptoms typically appear within 30 minutes to 2 hours after eating or drinking dairy. Some people can tolerate small amounts of lactose, while others are more sensitive.

Diagnosis of Lactose Intolerance

If you think you’re lactose intolerant, your doctor might:

• Ask about your symptoms and diet
• Suggest trying a lactose-free diet for a few weeks to see if symptoms improve
• Order a hydrogen breath test (a simple test that measures hydrogen in your breath after drinking a lactose solution)
• Do a stool acidity test, often used in children, or a lactose tolerance test

There’s no cure for lactose intolerance, but the symptoms can be managed easily with a few changes:

Dietary Changes

Avoid or limit foods with lactose, such as:

• Milk (cow, goat, sheep)
• Cheese
• Ice cream
• Butter
• Yogurt (although some types are easier to digest)
  
  

You can still get calcium and vitamin D from:

• Lactose-free milk or dairy
• Almond, soy and oat milks that are enriched with calcium provide a non-dairy option
• Leafy green vegetables, tofu or fish with bones (like sardines)
  
  

Lactase Enzyme Supplements

Over-the-counter lactase tablets or drops help break down lactose and can be taken before eating dairy. These work well for many people and allow more flexibility in your diet.

Probiotics

Some research suggests that probiotics — the “good” bacteria found in yogurt and supplements — may help improve lactose digestion over time.

How to Prevent Discomfort

If you're lactose intolerant, here are some helpful tips to prevent symptoms:

• Read food labels to check for hidden dairy ingredients
• Try lactose-free dairy or plant-based options
• Start with small amounts of dairy and increase slowly if tolerated
• Use lactase enzyme products before meals
• Eat or drink dairy along with other foods to slow digestion

If you regularly feel sick after drinking milk or eating cheese, talk to your health care provider. Managing lactose intolerance is usually simple and can help you enjoy meals without fear of discomfort.

By learning how your body reacts and finding the right balance, you can live well — even without dairy.

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