How to Cope with Lactose Intolerance

July 10th, 2013 by Eduardo Krajewski, MD, FACS, FASCRS

Maybe you know the feeling. You drink a glass of milk or eat some ice cream, and the next thing you know your stomach becomes bloated and gassy. Cramps, flatulence and diarrhea are usually not far behind. You might even end up with nausea and vomiting. Welcome to the unpleasant world of lactose intolerance.

However, there is some good news. You can learn to live with lactose intolerance… and even have your ice cream.

What is Lactose Intolerance?

Lactose is the sugar found in milk and dairy products. Lactose intolerance is a condition where you have inadequate levels of lactase which is an enzyme made by the lining of your small intestine. When quantities of this enzyme fall below a certain level, you can’t digest lactose and this leads to the bothersome symptoms.

Normally, lactase breaks down ingested lactose into glucose and galactose. These simple sugars can then be absorbed by the small intestine and transported to your blood. In lactase deficiency, the lactose merrily bypasses this digestive process and ends up in the colon. There it teams up with your gut bacteria to cause you problems. This concept is important for us to understand diagnosis and treatment.

What causes Lactose Intolerance?

For most people, the lactase level in their body naturally declines with age. The extent of this decline, among other factors, determines whether or not you develop lactose intolerance. In very rare cases a baby can be born intolerant to lactose due to a genetic disorder. Lactose intolerant babies cannot even tolerate their mother’s milk.

Other causes of lactose intolerance can be due to illness or injury such as:

  • Physical injury or surgery of the small intestine
  • Celiac disease
  • Gastroenteritis
  • Inflammatory bowel disease, Crohn’s Disease

How is it Diagnosed?

Your signs and symptoms are a pretty good diagnostic tool. You can even do some testing yourself. Lay off of milk and dairy products for a week or so and see how you feel. Then, try drinking some milk again. If your stomach starts acting up, then you have practically diagnosed yourself. You doctor can confirm the diagnosis with the following tests:

  • Lactose Tolerance Test: First your blood glucose levels are measured. Then you are given a glucose packed liquid to drink. Then your blood glucose is checked again after about two hours. If your body’s lactase level is adequate, then it will show in rising blood glucose levels.
  • Hydrogen Breath Test: When undigested lactose reaches the colon, a fermentation process occurs. This produces hydrogen and other gases. After drinking a glucose packed liquid, if your breath shows abnormally high levels of hydrogen, then you are probably lactose intolerant. Don’t light a match.
  • Stool Acidity Test: This test is more commonly used in children and infants. Undigested lactose creates lactic acid which can be detected in the stool.

Can Lactose Intolerance be Cured or Treated?

The condition can vary over time and your bodily state. For example, nearly half of lactose intolerant pregnant women find that they can drink milk during pregnancy. However, pregnancy is not a recommended treatment for lactose intolerance!

It is important, especially for women, to take into account your dietary calcium needs. Your doctor might recommend calcium supplements in pill form if you are not taking in any dairy products.

In general, several different treatment strategies can be tried. These are:

  1. Avoidance: You just simply avoid milk and dairy products. But there are some products you can try. For example, clarified butter has almost no lactose. Also, some yogurts are low in lactose. Cheese also has less lactose than milk, especially cheddar. Even ice cream is relatively low in lactose. Lactose free milk is also available at most supermarkets.
  2. Alternative products: Many people turn to soy milk. This can be used in anything that cow’s milk is used for including coffee, lattes, yogurts, and yes, even soy milk ice cream.
  3. Supplements: Lactase enzyme supplements are commercially available in tablet form. You might have to fiddle a bit with the timing of the dosage because if you take the supplement too late or early it won’t work.
  4. Lactase Rehab: Sometimes you can attempt to “train” the gut to tolerate lactose. This is done by consuming small amounts of lactose containing foods several times a day. If you have chronic intestinal disease, it is best to consult with a doctor before trying this method.
  5. Probiotics: These are bacteria, such as Lactobacillus acidophilus, can be included in the production of some milks and cheeses. This can aid in lactose digestion.


Lactose intolerance is very common, but it can be dealt with especially when we understand the biology behind its causes.

Please feel free to check out the rest of The H Doctor website. Here you will find some of the best information online about hemorrhoid treatment and other intestinal health topics.

Have an outstanding day.

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