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Lactose Intolerance

Digestion, Diarrhoea | June 22, 2018 | Author: Naturopath

diarrhoea, Digestion

Lactose Intolerance

Do you get bloating, nausea and abdominal cramps when you eat dairy products? It could be that you have a condition called lactose intolerance. To digest lactose (the sugar found in dairy products) the body releases an enzyme called lactase. In some people not enough lactase is produced when dairy products are consumed and this can lead to uncomfortable gastrointestinal symptoms. To manage the side-effects, it’s suggested that you minimise your lactose intake, avoid lactose altogether if the symptoms are severe or supplement with lactase when you consume dairy.

Lactase explained

Milk and other dairy products contain a sugar called lactose. When lactose enters the small intestine, an enzyme called lactase needs to be released to help break down lactose into two simple sugars glucose and galactose. These simple sugars are then absorbed into the bloodstream via the intestinal lining.

Undigested milk sugars

If you are lactose intolerant your body is deficient in the enzyme lactase. When lactose travels through the gut, instead of being broken down in the small intestine it instead reaches the large intestine. Undigested lactose interacts with gut bacteria where it is partially broken down into acids and gases. This fermentation process leads to the uncomfortable digestive symptoms such as gas, bloating and abdominal pain. In the intestinal tract, lactose attracts water molecules which results in watery stools and diarrhoea.

Symptoms of lactose intolerance

Symptoms of lactose intoleranceSymptoms of lactose intolerance usually appear within a short period of time after eating or drinking dairy products that contain lactose.

Common signs and symptoms include:

  • Nausea
  • Vomiting
  • Bloating
  • Abdominal cramps
  • Diarrhoea
  • Flatulence


Risk factors

Factors which increase your risk of lactose intolerance include:

Increasing age. Lactose intolerance is rare in babies and young children, as they are designed to digest lactose which in naturally found in breastmilk. However, as we age lactase production can decline.

Premature birth. Infants born premature haven’t developed the cells yet to produce lactase and may have reduced levels.

Ethnicity. It is rare for Caucasians to develop lactose intolerance. However, it is normal for lactose intolerance to develop after the age of five in people from Asia, Africa, the Middle East and some Mediterranean countries, as well as Aboriginal Australians. Up to five per cent of Caucasians and up to 75 per cent of non-Caucasians living in Australia are lactose intolerant.

Gastrointestinal diseases. Diseases that affect the small intestine can lead to lactose intolerance. Examples include inflammatory bowel disease, celiac disease and small intestinal bacterial overgrowth (SIBO).

Certain cancer treatments. If you have received radiation therapy for cancer in your abdomen or have intestinal complications from chemotherapy, you have an increased risk of lactose intolerance.

Types of lactose intolerance

Primary lactose intolerance

This is by far the most common type of lactose intolerance. Early in life our bodies produce plenty of lactase in order to get all of the nutrition from breast milk. As breast milk is replaced with other foods lactase production naturally decreases with age making dairy products difficult to digest. Primary lactose intolerance is due to our genetic makeup and is a common phenomenon in people with African, Asian or Hispanic ancestry.

Secondary lactose intolerance

This form of lactose intolerance occurs if there is damage to the small intestine which impairs lactase production. Damage to the small intestine can result from inflammation present in Crohn’s disease, side-effect from surgery, bacterial overgrowth and celiac disease. Treating the underlying disorder can help restore lactase levels and improve the side-effects of dairy consumption.

Congenital or developmental lactose intolerance

In rare instances babies can be born with a complete absence of lactase activity. The disorder is passed on through generations, where both the mother and father contribute a gene variant for the child to be affected. Infants born prematurely may also have insufficient lactase levels which can lead to lactose intolerance.

Living with lactose intolerance

If you have lactose intolerance this doesn’t necessarily mean that you must avoid dairy products altogether. Here are some dietary suggestions so that you can still enjoy dairy without any unpleasant side-effects.

Consume lactose free dairy

Living with lactose intoleranceThere are dairy products freely available in the supermarket which are lactose free. This means that you can still enjoy dairy products such as yoghurt, milk and cheese without any adverse reactions to lactose.

Limit dairy consumption

Every person has varying degrees of lactose intolerance and it is important to identify your tolerance levels. This involves finding the amount of dairy that you can consume on a daily basis without getting any adverse reactions. This could be a few slices of cheese, a tub of yoghurt or a small glass of milk.

Eat dairy low in lactose

Dairy products each contain varying amounts of lactose. Dairy products that contain higher amounts of lactose should be avoided or consumed in smaller quantities. These include:

  • milk
  • milk powder
  • condensed milk
  • evaporated milk
  • custard
  • ice-cream
  • frozen yoghurt
  • ricotta cheese

Dairy products with a lower lactose content include:Eat dairy low in lactose

  • cream
  • hard and soft cheeses
  • cottage cheese
  • butter
  • probiotic yoghurt
  • kefir
  • some dairy protein powders

Be aware that lactose can be found in other foods you may not suspect such as bread, pancakes, waffles, salad dressings and even some processed meats.

Lactase supplements

If you eat dairy products and suspect that you will experience symptoms you could try supplementing with a product containing lactase. These products are readily available in pharmacy and health food stores as tablets or drops. The drops are ideal for young children and can be added to foods that contain lactose to avoid symptoms.
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Gut repair

Sometimes lactose intolerance can come about because there is damage to the gut lining or poor digestive health in general. Ways to rectify this issue can include:

Antibacterial herbs: If a bacterial infection such as SIBO is contributing to your symptoms speak to your naturopath regarding a gut cleansing program.

Soothing: Herbs such as slippery elm and aloe vera are prebiotic foods that also have anti-inflammatory and healing properties to the gut lining.

Restore: Prebiotics such as galacto-oligosaccharide and probiotic strains such as Lactobacillus spp. can help restore levels of friendly bacteria in the colon to metabolise lactose.  Australia’s best online discount chemist


Deng Y, et al. Lactose Intolerance in Adults: Biological Mechanism and Dietary Management. Nutrients. 2015 Sep 18;7(9):8020-35

Staudacher H. Probiotics for lactose intolerance and irritable bowel syndrome. Br J Community Nurs. 2015 Jun-Jul;Suppl Nutrition:S12, S14

Savaiano DA, et al. Improving lactose digestion and symptoms of lactose intolerance with a novel galacto-oligosaccharide (RP-G28): a randomized, double-blind clinical trial. Nutr J. 2013 Dec 13;12:160. doi: 10.1186/1475-2891-12-160

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