What is it about ?
It is lactose intolerance when your body has difficulty digesting milk and certain dairy products. The cause is a lack of lactase (hypolactasia), an intestinal enzyme that helps digest lactose. If you are lactose intolerant, you will develop symptoms such as vomiting, cramps, diarrhea, or gas after eating or drinking dairy products. Lactose intolerance can be very troublesome, but it is not dangerous.
Lactose is a sugar (the sugar in milk), it can only be digested if lactase is present in sufficient quantities. People with hypolactasia do not make enough lactase. It is also possible that lactase is present in sufficient quantities, but that it is not working properly. In these situations, the lactose remains in the intestine. Flatulence is partly due to the fact that the bacteria in the colon use this lactose: they ferment it.
Lactose intolerance is not a allergy.
What is its frequency?
The classic form of lactose intolerance is common. The ability to produce enough lactase is determined genetically. Up to 18% of the population of northern Europe has hypolactasia. This percentage is even higher among people of Asian or African descent.
Children under 5 are usually not lactose intolerant. They produce enough lactase to be able to digest milk. There is a congenital form of lactose intolerance in infants, but it is very rare. Lactose intolerance can also be transient, after prolonged inflammation of the intestines. The intestines have been damaged, which temporarily prevents them from making enough lactase. In this situation, you may develop symptoms that persist for some time after an intestinal infection, but then go away on their own.
How to recognize it?
Symptoms appear exclusively when you consume products that contain lactose, such as milk, ice cream, certain cheeses, etc. You then have stomach aches, bloating, nausea, cramps, diarrhea and / or excessive gas.
How is the diagnosis made?
Describing your symptoms and how they relate to the consumption of products containing lactose is often enough for your doctor to conclude that you may be lactose intolerant. The risk of lactose intolerance is very high if other members of your family have it as well.
To be certain of the diagnosis, some specific tests can be performed:
- the lactose breath test: you start by drinking a liquid containing lactose, then you blow into different tubes to measure the digestion of the lactose. The test generally lasts 3 hours.
- the lactose tolerance test: you also start by drinking a liquid containing lactose, then some blood is drawn from you after 20, 40 and 60 minutes.
- there is a genetic test to detect lactose intolerance. This test only requires a blood test.
What can you do ?
It is not necessary to follow a strict lactose-free or milk-free diet, but after diagnosis it is still best to avoid all dairy products for 2-3 weeks. You can then reintroduce dairy products in amounts you tolerate. It may be that a single glass of milk does not cause any complaints, but you develop symptoms after drinking several or after combining several dairy products. Lactose intolerance is actually dose-dependent: the more lactose you take in, the more symptoms you may have.
If you think you are lactose intolerant, the most logical and effective step is to avoid milk and certain dairy products. Not all dairy products have the same lactose content. So you may tolerate some and not others. Thus, yoghurt or well-ripened cheeses contain little or no lactose. Keep in mind that some types of bread and other baked goods may also contain lactose. In addition, milk is often used in many preparations, such as some sausages and milk chocolate.
Milk is a source of calcium. Calcium is an essential mineral and the main component of the skeleton. If you are removing milk and dairy products from your diet, you need to get enough calcium from other foods.
If the lactose-free diet has no effect on your symptoms, see your doctor again. Another condition may possibly be the cause (celiac disease or gluten intolerance).
What can your doctor do?
There are capsules containing lactase. They can be effective. They are administered before meals.
If you are cutting out all dairy products, it may be advisable to take calcium supplements.
Want to know more?
- What is lactose – Health Passport
- Milk: for or against? – mongeneraliste.be – SSMG – Scientific Society of General Medicine
- Respiratory tests in gastroenterology – CHU Montreal
Are you looking for more specialized help?
- Find a registered dietitian – Professional Union of French-speaking dieticians
- Find a nutritionist doctor – Belgian Society of Nutritionist Doctors
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