Content

• To step
• Part 1 of 2: Recognizing the symptoms of lactose intolerance
• Part 2 of 2: Confirming lactose intolerance
• Tips
• Warning

Lactose intolerance is the inability to digest lactose, the main sugar in milk and other dairy products. It is caused by a complete lack or deficiency of lactase, the enzyme needed to digest lactose sugar in the small intestine. Lactose intolerance is not considered a life-threatening condition, but it can lead to significant stomach and intestinal complaints (bloating, abdominal pain, flatulence) and limits dietary choice. Many adults are lactose intolerant, but without having other medical complaints. Note that many other diseases and conditions also cause gastrointestinal (GI) problems, so being able to recognize symptoms of lactose intolerance is very helpful.

To step

Part 1 of 2: Recognizing the symptoms of lactose intolerance

1. Pay attention to stomach and intestinal complaints. As with many conditions, it is sometimes difficult to determine whether your physical symptoms are unusual or not normal. For example, if a person always has stomach and intestinal complaints after a meal, then that is "normal" for them and that person may assume that others feel the same way. But bloating, flatulence (gas), cramps, nausea and loose stools (diarrhea) after meals are not considered normal and are always a sign of digestive problems.
   • A variety of conditions and illnesses cause similar gastrointestinal symptoms and diagnosis can be difficult, but the first step is realizing that your digestive symptoms are not normal and should not be accepted as unavoidable.
   • Lactase splits lactose into two smaller sugars, glucose and galactose, which are absorbed by the small intestine and used by the body as energy.
   • Not all people with a lactose deficiency have digestive or gastrointestinal complaints - they produce low amounts, but it is enough to handle their dairy (lactose) consumption.
2. Check if your complaints are related to the consumption of dairy products. The typical signs and symptoms of lactose intolerance (bloating, abdominal pain, gas, and diarrhea) often start between 30 minutes to two hours after eating foods or drinks containing lactose. Therefore, check whether your stomach and intestinal complaints are related to the consumption of dairy products. Start with a lactose-free breakfast in the morning (read labels if you are unsure) and see how you feel. Compare that to eating lunch with some dairy products, such as cheese, yogurt and / or milk. If there is a significant difference in how your gut feels, you may be lactose intolerant.
   • If you experience bloating and flatulence after both meals, you may have a stomach or intestinal problem, such as inflammatory bowel disease or Crohn's disease.
   • If you feel pretty good after both meals, you may be allergic to something else in your diet.
   • This type of approach is usually referred to as an elimination diet, which means cutting out dairy products from your diet to determine the cause of your intestinal problems.
3. Know the difference between lactose intolerance and a milk allergy. Lactose intolerance is essentially an enzyme deficiency disease, which leads to undigested sugars (lactose) that eventually end up in the large intestine (colon). Once there, the normal intestinal flora overflows with the sugars and forms hydrogen gas (and some methane) as a byproduct, hence the bloating and flatulence that comes with lactose intolerance. A milk allergy, on the other hand, is an abnormal reaction of the immune system to milk products and often occurs within minutes of being exposed to the responsible protein (casein or whey). The symptoms of a milk allergy may include wheezing, hives (severe rash), swollen lips / mouth / throat, runny nose, watery eyes, vomiting and digestive problems.
   • Cow's milk allergy is one of the most common allergies affecting children.
   • Cow's milk is the usual cause of an allergic reaction, but milk from sheep, goats and other mammals can also cause an allergic reaction.
   • Adults with hay fever or food allergies are more likely to have a negative reaction to dairy products.
4. Know how lactose intolerance is linked to ethnicity. Although the amount of lactase produced in your small intestine decreases with age, it is also linked to your genes. In fact, the prevalence of lactase deficiency is quite high in certain ethnic groups. For example, about 90% of Asians and 80% of African Americans and Native Americans are lactose intolerant. The situation is least common among peoples of Northern European descent. So, if you are of Asian or African American descent and have frequent stomach and intestinal discomfort after meals, there is a very high probability that it is caused by lactose intolerance.
   • Lactose intolerance is uncommon in infants and toddlers regardless of ethnic background - it is a condition that usually does not appear until adulthood.
   • However, babies born prematurely sometimes have a poorer ability to produce lactase because of their underdeveloped intestines.

Part 2 of 2: Confirming lactose intolerance

1. Get a hydrogen breath test. The most commonly used test for the diagnosis of lactase deficiency is the hydrogen breath test. This test is done at your doctor's office or an outpatient clinic, but usually only after you have experimented with an elimination diet. The hydrogen breath test consists of drinking a sweet liquid with a lot of lactose (25 grams). Your doctor will then measure the amount of hydrogen gas in your breath at regular intervals (every 30 minutes). Little or no hydrogen is detected in people who can digest lactose; however, in lactose intolerant people, hydrogen perception will be much higher, as it ferments sugar in the colon by gut bacteria that produce the gas.
   • The hydrogen breath test is a great way to detect lactose intolerance because it is very reliable and convenient.
   • The test usually requires you to fast and not smoke the night before.
   • Too much lactose can cause false perception in some people, as can bacterial overgrowth in their intestinal tract.
2. Have a blood glucose / lactose tolerance test. The lactose tolerance test is a blood test to measure your body's response to consuming a lot of lactose (usually 50 grams). A glucose serum is used by your doctor as a baseline measurement after a fasting period and then compared with measurements one to two hours after drinking the lactose drink. If your blood glucose level does not rise 20 g / dl above the baseline reading within that time frame, it means that your body cannot properly digest and / or absorb the lactose.
   • The blood sugar / lactose tolerance test is an older method of diagnosing lactose intolerance and is less commonly used than the hydrogen breath test, but it can also be useful.
   • The blood sugar / lactose tolerance test has a sensitivity of 75% and a specificity of 96%.
   • False negative results occur with diabetes and intestinal bacterial overgrowth.
3. Have the acidity of your stool tested. Undigested lactose is made from lactic acid and other fatty acids in your colon, which end up in your stool. An acidity test, usually applied to infants and young children, can detect these acids from a stool sample. The child is given a small amount of lactose and then several consecutive stool samples are taken and tested for higher than normal acidity. A young child may also have glucose in the stool due to undigested lactose.
   • For infants and children who cannot have other lactose intolerance tests, a stool acidity test is a good alternative.
   • While this test is effective, the breath test is usually preferred for its simplicity and convenience.

Tips

• If you can't go without milk with your cereal or in your coffee, buy low-lactose or lactose-free products. You can also experiment with soy milk or almond milk.
• To help digest lactose, take lactase tablets or drops right before a meal or snack.
• Some dairy products, such as hard cheeses (Swiss cheese and cheddar), contain small amounts of lactose and often do not cause stomach or intestinal complaints.
• You may be less affected by low-fat dairy products (skimmed milk) than whole milk products.
• People can temporarily become lactose intolerant when they have other stomach and intestinal complaints, such as diarrhea on vacation.
• Foods with a lot of lactose are: cow's milk, milkshakes, whipped cream, coffee creamer, ice cream, sorbet, soft cheeses, butter, puddings, custards, cream sauces and yogurt.
• Some people with lactose intolerance can tolerate a glass of milk daily (240 ml = 11 g lactose). You may still be able to get dairy by spreading milk products throughout the day. In addition, some people can eat 1 to 2 glasses of milk or a similar amount of cream, ice cream or yogurt per day without experiencing significant symptoms.

Warning

• Lactose intolerance causes symptoms similar to other more serious stomach and intestinal disorders, so always talk to a doctor first rather than trying to diagnose yourself.
• It is important that with lactose intolerance and after eliminating dairy products, you still get enough calcium and other nutrients from dairy. Consult with your doctor if it is necessary for you to take a supplement, especially calcium and vitamin D.