Lactose Intolerance: Types, Causes, and Treatment

What is lactose intolerance?

There is a specific type of sugar found in cow’s milk, goat’s milk, sheep’s milk, breast milk, etc., known as lactose. People suffering from lactose intolerance (or lactose malabsorption) find it hard to digest this particular sugar.

A deficiency in lactase, the enzyme responsible for lactose digestion, is the main cause of lactose intolerance in people. But, this doesn’t always have to be the case as many people who produce low levels of lactase can still digest milk and dairy.

The main lactose intolerance symptoms to watch out for

Lactose intolerance comes with many symptoms that you can watch out for to determine whether you have it or not, and these can include:

• Diarrhoea - With lactose intolerance, the volume of water in your colon increases, leading to diarrhoea. But, this is more common in babies and young children than in adults. Not all carbohydrates that cause diarrhoea are due to lactose, though, and not all diarrhoea happens due to lactose intolerance.

• Stomach pain accompanied by bloating - This is a common symptom in both children and adults and happens because the body is unable to break down lactose, which ultimately passes through the gut and reaches the colon. When they cannot be broken down in the colon either, the fermentation leads to short, fatty acids being released, which lead to stomach pain and cramps. Bloating results when the same gas and water makes the gut wall stretch, giving the sensation of bulking up.

• Constipation - This symptom is much rarer than diarrhoea, but it can still happen due to undigested lactose fermenting in the colon. It produces methane gas, which is thought to slow down the food’s movement through the gut, possibly leading to constipation.

• Gas - The same fermentation of lactose produces hydrogen, methane and carbon dioxide in the colon increases flatulence in your body. The amount of gas produced varies from one person to another, but it’s interesting to note that the gases produced from lactose have no inherent odour. The odour actually comes from the proteins breaking down in the stomach, and not the carbohydrates.

• Nausea and vomiting - The bloating caused by the gases pressing against the gut results in nausea and vomiting in some cases. Also, because the body cannot digest the lactose, that also results in vomiting in a few.

• Other symptoms - Other symptoms of lactose intolerance may also include headaches, eczema, concentration loss, muscle and joint pains, fatigue, urination problem and even mouth ulcers in a few cases. But, these symptoms have not been established as a direct result of lactose intolerance yet.
  
  

What causes lactose intolerance?

There are three main types of lactose intolerance that is found in humans and these are caused and found in the following cases:

• Primary lactose intolerance - Mainly caused by genetic factors, this type of lactose intolerance is the most common type in this condition. As children start to eat solid food, the lactase quantity decreases as compared to when they were babies, resulting in primary lactose intolerance. But, in most cases, it’s not detected before they reach adulthood.

• Secondary lactose intolerance - Usually resulting from an injury, surgery or disease, this type of lactose intolerance usually forms in adulthood. In many cases, if the underlying condition is treated, secondary lactose intolerance shows an improvement. The most common causes of this include undergoing chemotherapy, bacterial infections and overgrowth, prolonged antibiotic courses and a few diseases like gastroenteritis, ulcerative colitis and Celiac disease.

• Developmental or congenital lactose intolerance - An autosomal recessive genetic disorder may sometimes result in babies being unable to produce lactase. But, this requires both parents to pass this genetic variant to the baby in order to be able to develop congenital lactose intolerance. And sometimes, premature babies develop this type due to not developing as much as they should before birth.
  
  

Can you do something about it?

There are a few steps you can take if you suspect lactose intolerance and these can include:

• Get an accurate diagnosis - The symptoms of lactose intolerance are very general in most cases, which is why it can be easily confused with other diseases. It is important to get a proper diagnosis before you proceed to cut out dairy from your diet and let these decisions rest on your doctor.

• Avoid high-lactose foods - If you’ve been diagnosed with lactose intolerance, you should avoid high-lactose foods such as cream, milk, cheese spread and even ice cream. But, people with lactose intolerance can usually tolerate up to 240 ml of milk when it is given at intervals throughout the day.
  
  
• Try low-lactose or lactose-free food - Milk and milk products are great sources of calcium and if you’re lactose intolerant, you may be scared that you will become deficient in the mineral. Thankfully, there are many low-lactose and lactose-free options that you can try in order to meet your calcium requirements and these include cheese, yoghurt, butter, soy or nut milk and heavy cream.