A person with lactose intolerance cannot eat or drink foods that contain lactose (milk sugar). Eating or drinking lactose-containing foods can cause unpleasant symptoms, such as abdominal pain and nausea. This is because there is little or no enzyme lactase in his or her gastrointestinal tract. This enzyme is necessary for breaking down milk sugar.
Lactose is found in dairy products such as milk, whipped cream, and yogurt. Dairy products from animals other than cows also contain lactose. Some hard cheeses no longer contain lactose due to the ripening process.
Because lactose is also in breast milk, all children are born with the enzyme lactase. In more than 80% of the world’s population, the lactase level decreases after the third year of life. For example, did you know that most people in Asia are lactose intolerant, while Europeans and North Americans generally continue to produce lactase?
What is lactose intolerance?
Lactose intolerance is one of the most common food intolerances in the Western world. Up to 30% of the population suffers from it (and in other regions of the world the percentage is even higher). Lactose intolerance is the result of a lactase deficiency and usually causes digestive problems after consuming foods containing lactose, such as cheese and other dairy products. That is why it is often referred to as ‘dairy intolerance’.
What is lactose and what does it contain?
Lactose is the sugar in milk and dairy products. It is also sometimes called milk sugar and can only be digested by the enzyme lactase, a protein that is produced in the small intestine. Lactose is among others in:
- Dairy products such as milk, cheese, yogurt, butter, and whipped cream
- Dessert, ice cream, pastries, cookies, and chocolate
- Bread and coffee cakes such as croissants and chocolate rolls
- Certain ready meals and soft drinks
- Broth cubes and soup
In addition, there are also certain medicines that contain lactose. This concerns small amounts, but it certainly does not hurt to mention it to your pharmacist.
The normal situation when you don’t have a lactase deficiency
Do you have enough lactase enzymes? Then everything goes back to normal. The enzyme lactase cuts lactose into small pieces, glucose, and galactose, nutrients that the small intestine can absorb.
What exactly happens with a lactase deficiency?
The body can only process lactose if the body’s own digestive enzyme lactase converts it into the nutrients glucose and galactose in the small intestine. However, lactose-intolerant people do not have (enough) lactase enzymes. And if there is no or too little lactase present, lactose is insufficiently broken down and cannot be absorbed through the small intestine.
This causes problems in the intestinal tract. The lactose ends up in its entirety, i.e. undigested, in the large intestine. The bacteria in the large intestine, also called the intestinal flora, will react to this. They will break down the lactose and ‘ferment’, but in doing so they make gas. This disrupts the balance in the intestinal flora, and this can lead to stomach and intestinal complaints.
Causes of lactase deficiency and lactose intolerance
Lactose intolerance can have several causes:
- Genetically determined or primary lactose intolerance ensures that lactose is broken down less well with age. Adults, therefore, have more problems with dairy products.
- Secondary lactose intolerance is caused by a damaged intestinal mucosa, for example by medication or disease. Unlike the genetic form, secondary lactose intolerance usually heals on its own when the intestines are functioning properly again.
- Congenital lactase deficiency is a condition in which a person can produce little or no lactase from birth. It is very rare, but it associates with a lifelong intolerance to lactose.
How often does it occur?
Does your body have a hard time digesting milk, cheese, and other dairy products? You’re not the only one. It is estimated that 70% of the world’s population is lactose intolerant to some degree. Quite a lot, isn’t it? And the older you get, the more likely you are to develop an intolerance, as your ability to produce lactase continues to decline.
By the way, did you know that lactose intolerance is hereditary and therefore carries genetic characteristics? In Northern Europe and the Middle East, countries where milk consumption used to be high, lactose intolerance is less common. In people of Asian or African origin, whose ancestors in certain regions knew less milk consumption, the intolerance rate quickly rises to 90%.
Main symptoms of lactose intolerance
Lactose intolerance is usually not dangerous, but it does cause some annoying symptoms. Are you lactose intolerant and do you eat a little too much food that contains lactose? Then about one and a half to two hours later, unpleasant complaints can occur:
- Abdominal pain and intestinal cramps
- Abdominal distention and bloating
- Flatulence and Diarrhea
- Nausea and vomiting
- Exceptionally, lactose intolerance can also be accompanied by other symptoms such as fatigue and weight gain
Note that lactose intolerance is not an allergy. It should not be confused with a cow’s milk allergy, a rare allergy in which the smallest amount of lactose can trigger a severe allergic reaction.
Can you get tested for lactose intolerance? How do you make the diagnosis?
Do you always have problems with your stomach and intestines after eating food such as fresh cheese, chocolate, and croissants? Then there is a very good chance that you are lactose intolerant. There is no test for food intolerance in general, but your doctor or pharmacy can help you determine whether or not you have lactose intolerance.
The following tests can help make the diagnosis:
- An interview and medical history of your family.
- Elimination challenge test, in which you follow an elimination diet for four to six weeks and do not eat products with lactose. No complaints? Then you can reintroduce the products into your diet and you can check whether the symptoms come back.
- Stool test, which measures the acidity of your stool. The more acidic the stool, the higher the chance that you are lactose intolerant.
- Blood sugar test, a test that measures the level of glucose in your blood after ingesting lactose. Do you have no problems digesting lactose? Then sugar particles (milk sugar) will appear in your blood. If there are none or hardly any, then you are probably lactose intolerant to a greater or lesser extent.
- A genetic test that can determine lactose intolerance through the cheek mucus.
- A hydrogen test, also call the lactose breath test, is taken in the hospital. After ingesting a liquid containing lactose, you have to breathe in tubes at different times. For example, it tests whether you exhale hydrogen, a by-product of intestinal flora that digest lactose, and therefore a very reliable indicator of lactose intolerance.
It is very crucial to make the correct diagnosis of lactose intolerance, so be sure to ask for a test or advice from your doctor or pharmacist. After all, there are conditions that have similar symptoms, such as irritable bowel syndrome (IBS) or cow’s milk allergy.
Lactose intolerance in babies and children
Babies and young children can also become lactose intolerant, but with a chance of 1 to 3 percent, it remains a rare phenomenon. Usually, babies only suffer from a temporary intolerance. This is possible, for example, when their intestinal tract is not yet sufficiently developed or when the intestines are temporarily damaged after a long-term intestinal infection. Persistent intolerance usually does not appear until between the ages of five and twenty.
Is there a suspicion of lactose intolerance in your baby or child? Then it is best to investigate the underlying cause, and whether it really is an intolerance, because the symptoms can also come from a cow’s milk allergy or be associated with immune diseases such as celiac disease or Crohn’s disease, which can cause temporary lactose intolerance.
Best treatments: what can you do yourself and have them done?
You are lactose intolerant, what now? You will probably need to make some lifestyle changes. But that doesn’t have to be the end of the world. A lactose-free diet and nutritional supplements such as lactase pills go hand in hand. This way you can still enjoy your favorite products with lactose. This recommends because dairy products contain many essential minerals and vitamins for your body.
If you discover that you are a victim of lactose intolerance. You advise following a diet based on lactose-free food in the first place. You always do this in consultation with a dietician, because experimenting with food yourself can have a negative impact on your body. Especially when you suddenly start cutting everything with lactose! This often not recommend because dairy contains important substances: vitamin B2; vitamin B12; and calcium, which is essential for your bones and teeth and prevents bone loss (also called osteoporosis) later in life.
Together with your dietitian, you check how sensitive your body is to lactose and how much you can take days because that is different for everyone. Based on this, you draw up an appropriate diet, in which you look for suitable substitutes: soy milk, rice milk, and almond milk are a few examples of this.
Medication for lactose intolerance?
The good news? If you have a lactase deficiency, a nutritional supplement based on lactase can compensate. This is an important tool, which gives you a better quality of life and also ensures that your body receives all the essential minerals and nutrients. You take it just before a meal and can eat whatever you want!
Here you will find two nutritional supplements that can help with lactose intolerance:
- Lactase supplements, so that your body can process lactose without any problems and you can enjoy your favorite dairy products such as cheese, milk, desserts, and chocolate without any worries. Lactosolv Extra Forte is an excellent alternative here, extra high dose, extra handy!
- Calcium supplements, before your body, had to contend with a calcium deficiency. With a daily requirement of 1000 mg calcium, it is best to take Calcium-D Forte EG, while with a daily requirement of 500 mg it is better to take Calcium-D EG.