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Lactose intolerance affects an estimated 30 to 50 million Americans today, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Many people may be affected by lactose intolerance without realizing it, writing off their symptoms as indigestion or food they shouldn’t have eaten.
Lactose intolerance stems from the body’s inability to digest lactose, a sugar found in milk products. The enzyme lactase, used to process lactose, is deficient in the system of people with this disorder. This enzyme is normally produced within the small intestine and breaks down lactose into two other sugars, glucose and galactose, which can then be absorbed into the body’s blood stream and used as energy. Without enough of the enzyme lactase, the lactose in milk products cannot be broken down.
Lactose intolerance often begins during childhood or young adulthood, when the body begins to feel uncomfortable after a milk product is consumed. This discomfort can last for up to two hours. Symptoms have a broad range, depending on an individual’s tolerance and how much milk sugar they consumed. Basic symptoms include stomach pain, bloating, gas, diarrhea and nausea.
To determine if an individual has a lactose intolerance, a physician can run different tests. One is the hydrogen breath test, which involves the person drinking something high in levels of lactose and then analyzing their breath to measure how much hydrogen is in it. This works because undigested lactose causes higher levels of hydrogen in the body, which is released in the breath.
Another test is the stool acidity test, mostly utilized for infants and small children. This measures the amount of acid in the stool, as undigested lactose creates lactic acid and other fatty acids that are easily found in a stool sample. Lactose intolerance is very uncommon for children under 2, so a doctor should be consulted if a child is having the symptoms listed above to explore other potential causes as well.
Individuals affected by lactose intolerance don’t have to abstain from all milk and milk products for the rest of their lives. Rather, they will have to temper their diet to discover how much they can consume without feeling sick.
Cheese and yogurt are lower in lactose than milk, and are often more easily tolerated. There are also many lactose-free and lactose-reduced products in grocery stores. Some of them have had the lactose removed entirely, while others have had the lactase enzyme added so that the body can process the lactose. If an individual’s tolerance is very low, there are also other products that are similar to dairy products that are made with soy or almonds that can serve as substitutes.
Lactase drops, capsules or tablets may also be taken when eating foods with lactase to render them digestible.
Not being able to digest lactose may lead to a deficiency of calcium, one of the foundations for strong bones. The National Institutes of Health recommends 1,000 mg of calcium a day, 1,200 if an individual is pregnant or nursing, and 1,500 for post-menopausal women. Those who cannot receive enough calcium due to lactose intolerance can take calcium supplements to help meet their nutritional requirements.
Note: Some people confuse lactose intolerance with a milk allergy, though it is not the same thing. A milk allergy is an individual’s body rejecting one or more of the proteins found in milk and can make the body very ill and even threaten life. Milk allergies are often found within the first year of life.
Sources: National Institute of Diabetes and Digestive and Kidney Diseases
National Institute of Health
Jackson/Siegelbaum Gastroenterology