Dr. Brian M. Kirsh, MD
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Lactose Intolerance

Lactose intolerance is the inability to digest significant amounts of lactose, the major sugar found in milk and dairy products.

What causes lactose intolerance?

Lactose intolerance results from a shortage of the enzyme lactase. Lactase breaks down milk sugar into simpler forms that can be absorbed into the blood stream. When there is not enough lactase to digest the amount of lactose consumed, the results are not dangerous, but the symptoms of lactose intolerance can be uncomfortable.

What are the signs and symptoms of lactose intolerance?

Common symptoms may range from mild to severe including nausea, cramps, bloating, gas, and diarrhea. Symptoms begin about 30 minutes to 3 hours after eating or drinking foods containing lactose. The severity of symptoms depends on many factors, including the amount of lactose a person can tolerate and a person's age, ethnicity, and digestion rate.

How is lactose intolerance diagnosed?

A common test used to measure the absorption of lactose in the digestive system is the hydrogen breath test. This test measures the level of a gas called hydrogen in your breath. Hydrogen is produced by bacteria in the colon (large intestine) in response to undigested lactose. Hydrogen is carried through the blood stream to the lungs, where it is breathed (exhaled) out. High levels of hydrogen in your breath means that lactose is not being digested properly.

Treatment Options and Prevention

Lactose intolerance is relatively easy to treat. The amount of lactase enzyme that the body produces cannot be increased, but symptoms can be controlled through diet. Many children and adults do not need to avoid lactose completely, but individuals differ in the amounts of lactose they can handle.

To reduce symptoms of lactose intolerance:
  • Choose soy milk, rice milk or even try almond milk
  • Choose soy yogurt, coconut yogurt or rice yogurt
  • Choose low-lactose dairy products such as aged cheese, cream cheese or sherbet
  • Choose special dairy products such as Lactaid® milk, Lactaid® ice cream, Lactaid® cottage cheese, Lactaid® or milk
  • Use lactose containing tablets such as Lactaid® or Dairy Ease® with dairy products.
  • Be aware of hidden or added sources of lactose in dry milk solids, non-fat dry milk-powder, whey, curds, and in milk by-products.
  • Limit your quantity of dairy products; even people with lactose intolerance can usually tolerate small amounts of dairy products.

Seeking medical advice

If you have signs and symptoms of lactose intolerance, call 216-593-7700 to schedule an appointment with one of our physicians.