Lactose intolerance arises when your body struggles to interrupt down lactose, the natural sugar present in dairy products. It occurs primarily when your small intestine lacks sufficient lactase, an enzyme vital for lactose digestion. 

The onset of lactose intolerance can occur at any point in life, no matter prior experiences with milk and its products. While some people cope with lifelong lactose intolerance from childhood, others may develop intolerance as they age. Moreover, the production of lactase can either diminish significantly or stop altogether through the transition to maturity and beyond. Medical conditions disrupting the gut’s health and functionality are the common triggers for the sudden onset of lactose intolerance.

Lactose Intolerance: An Overview

Lactose intolerance is when the body struggles to digest lactose, a natural sugar in milk and most dairy products. Breast milk and standard infant formulas also contain lactose as the first dietary sugar. When undigested lactose passes through the massive intestine, it might result in discomfort, including symptoms like gas, abdominal pain, and bloating. 

The extent and severity of lactose intolerance vary from individual to individual. While some may experience difficulty digesting any amount of milk products, others can tolerate modest amounts or specific types without issues.

There may be a broad spectrum of lactose intolerance, starting from individuals with no tolerance for dairy to those that can digest certain dairy products like milk chocolate, hard cheeses or yoghurt. The 4 essential sorts of lactose intolerance include:

Primary Intolerance

Individuals who experience primary lactose intolerance initially produce sufficient lactase within the infant stage and childhood. As children transition to a more varied food plan, the natural decline in lactase production occurs. Nonetheless, it typically stays at a level sufficient to digest the quantity of dairy in an ordinary adult food plan. In cases of primary lactose intolerance, lactase production experiences a big decline by maturity, making the digestion of milk products difficult. It’s essentially the most common variety of lactose intolerance. 

Secondary Intolerance

Damage to the gut lining, where lactase is produced, results in secondary lactose intolerance. The common triggers are gut infections, illnesses, or intestinal surgery. It’s also referred to as acquired lactase deficiency.

Developmental Intolerance

Developmental intolerance occurs in prematurely born babies as a result of underdeveloped small intestines, resulting in temporary lactose intolerance.

Congenital Lactose Intolerance

Congenital lactose intolerance is a condition affecting infants. It’s a rare condition that arises when infants are born with a deficiency or absence of the enzyme lactase. This condition occurs when babies receive one gene answerable for this deficiency from each parent despite each parents being lactose tolerant. 

Signs and Symptoms of Lactose Intolerance

While less common, some lactose intolerant people have reported experiencing symptoms reminiscent of headaches, difficulty concentrating, muscle and joint pain, fatigue, mouth ulcers, problems with urination, and eczema. The next are the five mostly observed signs and symptoms of lactose intolerance.

Stomach Pain

The cells lining the colon cannot absorb carbohydrates like lactose. Nonetheless, naturally occurring bacteria, referred to as microflora, ferment and break down these carbohydrates. This fermentation process releases short-chain fatty acids, together with gases like hydrogen, carbon dioxide, and methane. This accumulation of acids and gases causes stomach pain and cramps. The pain is often concentrated across the navel and the lower abdominal region.

Nausea

Lactose intolerance can result in nausea and, in some cases, vomiting, particularly in children. In actual fact, nausea is the second commonest symptom related to lactose intolerance, following abdominal pain. The resulting gases and volatile fatty acids when lactose ferments within the gut are the essential causative aspects for inducing feelings of sickness. 

Diarrhoea

Lactose intolerance causes diarrhoea by increasing the water volume within the colon, consequently increasing the liquid content and overall volume of the stool. Nonetheless, experiencing diarrhoea doesn’t necessarily indicate lactose intolerance. Various aspects reminiscent of food plan, other sorts of malabsorption, medications, infections, and inflammatory bowel diseases can even contribute to this symptom.

Inside the colon, the fermentation of lactose causes the production of short-chain fatty acids and gases. While the vast majority of these acids are reabsorbed into the colon, not all are. The remaining acids, together with unprocessed lactose, contribute to an increased release of water into the colon. It might probably cause diarrhoea or frequent, watery stools.

Gassy Feeling

The lactose fermentation within the colon increases the production of methane, hydrogen, and carbon dioxide gases, which further increases flatulence. Unlike when proteins break down within the gut, which may release smelly sulphur compounds causing the odour in flatulence, lactose fermentation mainly produces gases with no noticeable smell.

Constipation

While diarrhoea is a more common lactose intolerance symptom, some may experience constipation as a substitute. It occurs since the small intestine doesn’t properly digest lactose, allowing it to maneuver into the colon, where it might affect water absorption and reduce bowel movements.

While lactose intolerance and dairy allergy may share some symptoms and require the removal of dairy from one’s food plan, they’re different conditions. Lactose intolerance pertains to the digestive system, whereas dairy allergy involves the immune system. Although dairy allergy may manifest some similar symptoms as lactose intolerance, it’s an immune system issue and might be more severe, potentially even life-threatening.

Along with common symptoms reminiscent of bloating, gas, cramps, diarrhoea, and nausea, individuals with dairy allergy also experience respiratory problems, hives, and swelling of the throat and lips. It’s crucial to recognise the difference between these conditions, as dairy allergy poses a heightened risk and requires careful management.

Causes of Sudden Lactose Intolerance

Lactose intolerance can develop at any age, including well into maturity. It’s because lactose intolerance is influenced not only by the expression of lactase but additionally by aspects reminiscent of the cumulative intake of lactose over time, the composition of intestinal flora, and the sensitivity of the gastrointestinal tract. All these aspects can change as you age. 

Sudden-onset lactose intolerance is often categorised as secondary lactose intolerance, and the leading causes of this condition are below:

Illness or Injury

Intestinal diseases like celiac disease, Crohn’s disease, ulcerative colitis, inflammatory bowel disease (IBD), surgeries, or injuries to the small intestine cause sudden lactose intolerance. Drinking inadequately treated or untreated water can even cause damage to your bowel, potentially resulting in lactose intolerance. Treating the underlying disorder may restore lactase levels.

Medications

A medicine you take may increase your sensitivity to dairy. Common triggers include antibiotics. Ropinirole, Colchicine, Entecavir, and Zaleplon are some common drugs known to have lactose intolerance as a side effect. Moreover, there have been occasional cases where patients undergoing thionamide therapy and chemotherapy treatments experienced symptoms of lactose intolerance, including severe diarrhoea.

Ageing

Typically, ageing increases sensitivity to digestive issues, reminiscent of feeling bloated after meals. Moreover, consuming caffeine or spicy foods that irritate the intestinal lining or stimulate the gut to contract more quickly can mimic symptoms of lactose intolerance.

Going Dairy-Free

People accustomed to including lactose of their food plan possess significantly higher levels of the lactase enzyme, six to eight times more, in comparison with those that don’t eat lactose. They’re more efficient at digesting lactose, which helps prevent symptoms. Nonetheless, abruptly eliminating high-lactose foods out of your food plan can result in lactose intolerance symptoms upon reintroduction, at the least temporarily. 

Refraining from consuming high-lactose foods can alter your colon bacteria, reducing the variety of lactose-digesting bacteria. Consequently, reintroducing lactose in a considerable amount may result in symptoms. Subsequently, it’s advised to not adopt a dairy-free food plan unless crucial. If you could have already done so and need to reintroduce dairy products, it is suggested that you just do it step by step.

The best way to Manage Lactose Intolerance

In the event you suspect that chances are you’ll be experiencing the symptoms of lactose intolerance, it’s advisable to seek the advice of with a health care provider. In the event you naturally avoid milk-based products, there may be a risk of becoming deficient in essential nutrients reminiscent of calcium, vitamin D, riboflavin, and protein. Subsequently, it’s all the time really helpful to hunt guidance from a good platform like HealthifyMe and seek the advice of with a nutritionist. It can allow you to understand and create a food plan plan that aligns along with your body and lifestyle, ensuring you don’t encounter any unwanted deficiencies or discomfort.

When adjusting to a lactose-free food plan and lifestyle, rigorously read food labels to discover ingredients containing lactose. Removing milk and its products from the food plan may help manage symptoms. Nonetheless, other than milk, concentrate to ingredients derived from milk, including:

• Cheese
• Butter
• Yoghurt
• Margarine
• Dry milk solids or powder
• Whey or whey protein concentrate
• Casein or caseinates
• Curds

Note: Hard cheeses like cheddar and Swiss generally contain less lactose than soft cheeses. Yoghurt can be considered easier to digest than other dairy forms. 

You can’t prevent lactose intolerance, but you’ll be able to minimise symptoms by consuming less dairy. Selecting low-fat or fat-free milk can also reduce symptoms. Consider trying dairy milk alternatives reminiscent of almond, flax, soy, or rice milk. Taking lactase pills or drops, reminiscent of Lactaid or Dairy Ease, before eating can even help manage symptoms.

You possibly can still obtain sufficient calcium without consuming dairy through various sources. Some good non-dairy options for calcium include:

• Calcium-fortified foods: These include juices, breads, and non-dairy milks like almond, soy, and oat milk. Soy-based products like tofu and tempeh might be excellent sources of calcium, especially in the event that they are processed with calcium sulphate.
• Boned fish: Fish with bones, reminiscent of sardines or salmon, are wealthy in calcium. It’s essential to notice that not all fish are high in calcium, and the calcium content can vary.
• High calcium plant foods: Plant-based foods like kale, collard greens, bok choy, and broccoli contain reasonable amounts of calcium. 

HealthifyMe Suggestion

When you’re lactose intolerant, it’s essential to avoid dairy products and ingredients that contain lactose. Some common foods to look at out for include milk, cheese, yoghurt, butter, cream, ice cream, sour cream and certain processed foods which will contain lactose as an ingredient. At all times check labels for terms like lactose, milk solids, whey, casein, buttermilk, and dry milk powder as these indicate the presence of dairy. Baked goods (cakes, cookies, pastries) may contain milk or butter, processed meats (like sausages and deli meats) may contain milk solids or whey, and salad dressings and sauces may use milk or cream as a base. When shopping, all the time rigorously read labels and in the event you’re unsure a few product, it’s best to decide on alternatives labelled as lactose-free or dairy-free. 

The Final Word

Secondary lactose intolerance, often sudden in onset, results from various causes reminiscent of illness, medication, ageing, and dietary changes. Addressing secondary lactose intolerance involves treating the foundation causes, reminiscent of illnesses or injuries to the intestines, medication-related sensitivities, and age-related changes. 

While minimising dairy consumption can alleviate symptoms, it’s essential to keep up adequate intake of essential nutrients like calcium, vitamin D, riboflavin, and protein. For effective management, in search of skilled guidance, consulting with a health care provider, and dealing with a nutritionist may help create a well-balanced food plan that meets dietary needs without causing discomfort. 

Disclaimer: The aim of this text is simply to disperse knowledge and lift awareness. It doesn’t intend to switch medical advice from professionals. For further information, please contact our certified nutritionists Here.

Research Sources

Lactose Intolerance

Diarrhoea attributable to carbohydrate malabsorption

Lactose Intolerance in Adults: Biological Mechanism and Dietary Management

Lactose intolerance following antithyroid drug medications

Ceaselessly Asked Questions (FAQs)