Dietary Guideline for Lactose Intolerance

An individual with lactose intolerance is unable to digest lactose due to a lactase deficiency. Lactose is a sugar commonly found in milk and dairy products, whereas lactase is an enzyme produced by the small intestine and is responsible for breaking down lactose into glucose and galactose before they are absorbed into the bloodstream.

When a person with lactose intolerance consumes food or drink containing lactose, the undigested lactose will pass through the colon and cause a range of gastrointestinal symptoms. It is then fermented by bacteria which leads to gas production and other by-products.

There is a misconception that lactose intolerance is considered as a milk allergy. However, this is not the case as lactose intolerance is caused by the lack of the lactase enzyme in an individual’s small intestine.

Causes of Lactose Intolerance

Lactose intolerance is caused by the body’s inability to produce enough lactase. Lactase is a type of protein and enzyme that assists in regulating chemical reactions, and it is usually produced in the small intestine to aid in the digestion of lactose.

A lactase deficiency is due to the body not producing enough lactase. Lower levels of lactase enzymes in some individuals’ bodies make it challenging for the body to break down lactose into usable sugars such as glucose and galactose.

There are four main causes of enzyme deficiency.

Lactase deficiency	Details
Primary lactase deficiency	The main cause of lactose intolerance worldwide. Results from an inherited genetic defect that has been passed down through generations within families. Occurs in a person when a person’s diet shifts away from milk and dairy products causing them to have a decline in lactase production. This reduction in milk consumption usually happens after the age of two, once breastfeeding or bottle-feeding has stopped, though symptoms may not appear until later in life.
Secondary lactase deficiency	May occur due to an injury to the lining of the intestine, which can be caused by various infections, inflammations, or other illnesses like gastroenteritis, celiac disease, Crohn’s disease, ulcerative colitis, chemotherapy, and usage of antibiotics.
Congenital lactase deficiency	A rare hereditary condition affecting newborns, caused by parents who both carry a copy of a faulty gene that is then passed on to their child. The child produces little to no lactase in their bodies, thus causing difficulty in breaking down lactose in dairy products.
Developmental lactase deficiency	A condition that happens in babies born prematurely before the 37th week of pregnancy when the small intestines were not completely developed, so they have difficulties breaking down lactose. However, their intestines will mature over time as they grow older, resulting in them developing enough lactase activity to digest lactose effectively.

Symptoms of Lactose Intolerance

The symptoms are easily noticeable within thirty minutes to two hours after consumption of dairy products. They include diarrhoea, bloating, abdominal pain, nausea or vomiting, feeling overly full, and passing excessive gas.

The severity of symptoms varies from person to person, and not everyone will experience all of the symptoms listed. Consult your doctor if you have any doubts or concerns.

Diagnostic Tests

A combination of clinical assessment and specific tests are used to diagnose lactose intolerance.

The hydrogen breath test requires you to drink a lactose-rich solution, and then breathe into a device that measures the hydrogen level in your breath. If the hydrogen levels are high, it indicates that lactose is not effectively broken down and it is fermented by bacteria in the colon. This suggests that you have lactose intolerance.

Lactose tolerance test is a common test that measures your blood sugar level after consuming a lactose-rich solution. If your blood sugar level does not rise significantly during this period, it suggests that you may have lactose intolerance.

Treatment and Management

Avoid or reduce consumption of dairy products like milk, cheese, ice cream and yogurt to 10g per day.
Check food labels for lactose content, as lactose can also be found in other products such as bread, cereals, and processed foods.
Choose lactose-free or lactose-reduced milk and dairy products.
Choose dairy-free alternatives such as almond milk, soy milk, oat milk, and coconut milk that can be used as substitutes.
Slowly reintroducing dairy products into your diet can help determine the threshold that you can tolerate without experiencing symptoms. Some individuals with lactose intolerance can tolerate a small amount of lactose.
Consume foods that are rich in calcium like green leafy vegetables (kale and broccoli), almonds, tofu, and fortified foods (orange juice and cereals).
Consider taking vitamin D supplements to support calcium absorption and bone health.
Lactase enzyme supplements may be taken to assist in the breakdown of lactose and reduce symptoms.

Make an Appointment at Gleneagles Hospitals

Consult our doctors if you are showing lactose intolerance symptoms. A dedicated and expert team of Gastroenterologists at Gleneagles Hospitals is available for consultation to provide the best care and assistance.

Get in touch with us to book an appointment today if you have concerns or questions regarding lactose intolerance. We assure you the best possible care tailored to your specific needs.