Lactose Intolerance

Lactose intolerance is possibly the most commonplace of all dietary sensitivities. Also known as lactose malabsorption, it's estimated that 68% of people across the globe live with some form of lactose intolerance. This makes it essential to understand the concern, recognise the symptoms, and work out how you can live with it.

What is Lactose Intolerance?

Dairy products contain a naturally occurring sugar called lactose. When we consume dairy, this sugar is broken down by an enzyme in the small intestine called lactase – note the slightly different spelling.

If you're lactose intolerant, your body does not produce or host lactase. This makes lactose impossible to break down. Instead, the sugars of the dairy are moved into the large intestine, where they mingle with natural gut bacteria. This can lead to digestive discomfort.

There are three forms of lactose intolerance:

• Developmental lactose intolerance means that somebody is born without the lactase enzyme – usually having inherited lactose intolerance from a parent. In such an instance, an infant will struggle to digest breast milk. Thankfully, developmental lactose intolerance is rare
• Primary lactose intolerance is much more common. This form of lactose intolerance comes with age, especially when lactase becomes less essential to the diet. The less lactose is consumed, the more the body struggles to break it down
• Secondary lactose intolerance refers to lactose intolerance that arises as a symptom of a different ailment. Inflammatory Bowel Disease often leads to lactose intolerance, as does celiac disease and potentially intestinal surgery

Anybody can develop primary lactose tolerance over time, but the concern is most common in people of Asian and African ancestry. This is due to the low reliance on dairy in these ethnic cuisines.

Symptoms of Lactose Intolerance 

The symptoms of lactose intolerance almost exclusively revolve around the digestive tract. The following concerns are signs of the issue.

• Bloating
• Painful stomach cramps
• Feeling nauseous
• Consistent flatulence
• Stomach upsets

These symptoms usually arise within about 30 minutes of consuming lactose, but it can take up to two hours.

Diagnosing Lactose Intolerance

If you think you may be lactose intolerant, start minimising your dairy consumption and keep a diary of your symptoms – or lack thereof. You will need to discuss your concerns with a healthcare professional eventually, but access to this information will make diagnosis easier.

If you have a strong suspicion that you are lactose intolerant after going through any motions of replacing foodstuffs or upping intake, you really need to take a health test and then present yourself with the results to your medical practitioner. Once the test is formalised as a verdict of lactose intolerance, your GP may issue a hydrogen breath test. You will be asked to drink a lactose-heavy liquid and periodically blow into a bag (similar to a police roadside breathalyser) over several hours. The hydrogen particles on your breath will then be analysed.

A healthy digestive tract with no sensitivity will offer hydrogen levels below 16 parts per million, or ppm. If your results are higher than this, it suggests your body is struggling to digest lactose. If this is the case, you will likely be invited to take a blood test.

This will determine the levels of glucose in your blood. A lactose intolerance diagnosis will be confirmed if the glucose level has not risen in the several hours since you consumed the lactose-centric liquid. Your body is not digesting and processing the sugars found in lactose.

Risks and Hazards of Lactose Intolerance 

The symptoms of lactose intolerance are rarely dangerous or life-threatening, though they can be inconvenient – and a little embarrassing!

The most significant hazard of lactose intolerance, especially in children, is a potential lack of calcium. Dairy products are the biggest provider of this. If you are lactose intolerant, consider upping your intake of the following foods:

• Leafy greens, especially kale
• Soya-based products. Soy milk is a popular substitute for cow's milk, but you can also try soy cheese and other goods
• Bread
• Fresh fish. For the avoidance of doubt, that means fish with scales and bones or filleted, not breadcrumbs or batter! 

These are all high in calcium, which will go some way to negating the absence of this crucial nutrient due to limited dairy in your diet.

Can Lactose Intolerance be Cured? 

Lactose intolerance, in and of itself, is not a disease and thus does not need to be cured. In many respects, it's best to acknowledge the body's limitations when living with lactose intolerance and work around the conditions' restrictions. If a secondary illness causes the concern, focus on that.

Do not attempt to 'reverse' primary lactose intolerance by increasing the amount of dairy in your diet. There are no guarantees that exposure therapy will garner positive results, and you'll likely just put yourself through significant gastric distress for no reason.

Managing Lactose Intolerance

There are ways that the impact of lactose intolerance can be managed and negotiated. The first and arguably most effective remedy is to invest in lactase supplements. You can find these in any reputable health food shop. However, it is always important to discuss the use of supplements with your doctor, before embarking on them, or any other supplementation.

After a definite diagnosis, and consultation with your doctor or other medical professional, you can take a lactase supplement before eating and – in theory – you will be able to enjoy milk, cheese, ice cream, or any of the foods commonly linked to discomfort. If your intolerance is severe, however, it's advisable to discuss the use of lactase supplements with a healthcare professional – and be aware that lactase supplements will do nothing to ease symptoms of some other conditions, such as coeliac.

The best way to manage lactose intolerance, however, is to adjust your diet. Many brands now offer lactose-free versions of traditional dairy products in mainstream supermarkets. Alternatively, switch dairy-heavy products for alternatives – replace ice cream with frozen yoghurt, change out conventional milk for a soy, oat, or almond-based alternative, and use a cheese without lactase such as brie, parmesan, or gouda.

Most importantly, do address the problem, and don’t just leave it because you don’t like the taste of ‘non-cows milk’, or ‘can’t live without an ice cream fix’. There are millions of people worldwide who have made adjustments, and enjoy a non-dairy diet to the full. Be one of them and keep healthy!