Lactose Intolerance

Lactose intolerance is the inability to fully digest lactose, the sugar found in milk and dairy products, due to insufficient levels of the enzyme lactase. It is very common, particularly among adults of certain ethnic backgrounds, and is different from a milk allergy.

• Bloating and abdominal cramps after consuming milk or dairy products
• Diarrhoea
• Excess gas
• Nausea
• Symptoms typically appear within 30 minutes to a couple of hours after consuming lactose-containing foods

• Results from reduced activity of lactase, the enzyme that breaks down lactose in the small intestine, allowing undigested lactose to pass into the large intestine where it causes symptoms.
• Most commonly develops naturally with age, as lactase levels decline after childhood in many people, particularly in certain populations.
• Can also occur temporarily after a gut infection or illness that damages the intestinal lining.

• Often suspected based on a clear pattern of symptoms following dairy consumption, improving when dairy is avoided.
• A trial of eliminating lactose from the diet, followed by reintroduction, can help confirm the diagnosis.
• Specific testing (such as a hydrogen breath test), where available, can confirm lactose malabsorption in less clear cases.

Reducing or avoiding lactose-containing foods, guided by individual tolerance, is the main approach to managing symptoms.

Many people with lactose intolerance can tolerate small amounts of dairy or lactose-reduced products without symptoms, so complete avoidance is not always necessary.

Lactase enzyme supplements, taken with dairy-containing meals, can help some people digest lactose more comfortably where available.

Ensuring adequate calcium and vitamin D intake from other sources is important if dairy intake is significantly reduced.

• Identify your personal level of tolerance through gradual reintroduction of dairy in small amounts.
• Choose lactose-reduced or lactose-free dairy products where available and preferred.
• Ensure adequate calcium intake from non-dairy sources, such as leafy greens, if avoiding dairy.
• Consider lactase enzyme supplements before consuming dairy, if tolerated and available.