An hour has passed since you ate a couple of slices of pizza, and you’re gripping your belly and doubling over with cramps. You feel like you might have a loose bowel movement. And this is not the first time it’s happened. Last week you ate a bowl of ice cream and ended up being embarrassingly gassy. Does this sound familiar? You could have lactose intolerance.


Lactose intolerance is a common digestive problem where the body is not able to digest lactose, a natural sugar mainly found in milk and other dairy products. Lactose is normally digested or broken down by an enzyme called lactase which is manufactured in our small intestines. Lactose intolerance is the condition where the body does not make enough of the enzyme lactase, and therefore cannot easily digest or break down the sugar lactose.




Lactose intolerance is not a food allergy. Food allergies are reactions to a food by our immune system, causing symptoms like rash, wheezing, or itching. Simply put, if you have lactose intolerance, you may love milk, but your body doesn’t. When lactose moves through your gut without being properly broken down, it causes uncomfortable symptoms like pain, bloating, and gas. This intolerance to lactose is not an all-or-none phenomenon. It can vary in severity – some people with severe lactose intolerance may not be able to digest any dairy products at all, while others with a milder degree of the condition may tolerate small to moderate amounts of dairy or certain types of milk products with minimal or no symptoms. 




You are not alone. Millions of people around the world have lactose intolerance. Its incidence varies greatly in different ethnic groups. Lactose intolerance is more commonly seen in people of Native American, Asian, African, and South American descent compared to people of European descent. Only 1 in 50 people of northern European descent are known to have lactose intolerance, while most people of Chinese descent have some form of the condition. It is speculated that people living in places that historically had no access to milk did not evolve the ability to digest lactose. 




Although lactose intolerance can develop at any age, many first cases are diagnosed in people aged 20 to 40. It may also evolve slowly with age because the production of lactase enzyme decreases with age. Lactose intolerance has been noted to run in families. If symptoms develop during the teen or adult years, those afflicted can usually consume some milk or dairy products without problems. In the rare case when a newborn is found to be lactose intolerant, they cannot eat or drink anything containing lactose. Premature babies may have temporary lactose intolerance from inability to make lactase, but in these cases the condition is typically self limited. Sometimes the small intestine may stop the production of the enzyme lactase after an illness such as a stomach infection or surgery in which a part of the small intestine is removed. In these cases, the lactose intolerance can be either permanent or temporary.




The simplest test to diagnose lactose intolerance is a milk challenge, i.e., eliminating milk and dairy from the diet and observing for improvement in symptoms.


Lactose intolerance is primarily treated with dietary changes and supplements of lactase enzyme. Avoidance of milk and milk-containing products is all very well, but dairy products like milk, cream, cheese, butter, and ice cream are calcium-rich foods. The biggest challenge lactose-intolerant people face is to ingest an amount of calcium sufficient enough to maintain healthy bones, without being in constant discomfort from the foods they are intolerant to.


While lactose intolerance is an uncomfortable and sometimes lifestyle-limiting disease, it is usually harmless, and most people can learn to manage the condition without having to give up all dairy foods. You can’t cure lactose intolerance, but by changing what and how you eat, you may ease or even completely get rid of your symptoms.