Ever wonder why grandpa creates his own symphony of sounds after eating ice cream? It’s because he doesn’t produce enough of the enzyme lactase, which gradually diminishes as we age.
Lactose intolerance is very common. Some 30 to 50 million Americans and roughly 65 percent of adults worldwide have lactose intolerance.1 We produce a sufficient amount of lactase in our childhood, but the majority of adults will see a reduction or cessation of lactase production in their lifetime.
What Is Lactose Intolerance?
Lactose is the sugar found in dairy products like ice cream, cheese and yogurt. It is a component of milk produced by mammals, such as cows, goats and sheep.
The lactose molecule is comprised of two smaller sugar molecules bound together: glucose and galactose. Lactase is the enzyme that breaks down the lactose molecule into these two smaller molecules.
If there isn’t enough lactase, lactose will not be absorbed by the microvilli that lines the small intestine, leading to a buildup of lactose in the gut. Here, lactose can begin to curdle and create occasional gas, bloating, diarrhea and a range of other digestive issues.
The severity of symptoms related to lactose intolerance depend upon the amount of lactose consumed and the degree of lactase insufficiency.
How Does the Enzyme Lactase Improve Digestion?
The small intestine can be compared to a kitchen colander used to strain pasta. The colander’s holes allow passage of only a certain size of molecule. Lactose is too large to pass through the walls of the small intestine. But when lactase breaks lactose down into glucose and galactose, these smaller molecules are able to pass through the small intestine into the bloodstream and nourish the body.
If lactose is not broken down, however, it is too large to pass through the small intestine, leading to a buildup of lactose and a myriad of discomforts. Not only are these symptoms uncomfortable, and sometimes embarrassing, but the body doesn’t receive the food’s nutrients, leading to fatigue and a general lack of wellbeing.
What Causes Lactose Intolerance?
Lactose Intolerance can be caused by a variety of factors, including your genetics, age and other lifestyle factors.
In fact, the prevalence of lactose intolerance in the world is also modulated by race and region. In some Asian countries, upwards of 90 percent of the population is lactose intolerant.
Regardless of if you develop a congenital lactose intolerance at birth, or acquire a new lactase deficiency as you age, the symptoms are typically the same.
How Is Lactose Intolerance Diagnosed
Step one is the elimination diet. Remove milk products from your diet and see if your symptoms improve. To confirm your results, follow up testing includes stool acidity, oral lactose tolerance, genetic evaluation or a breath test.
Breath testing provides one of the most reliable means of determining lactose malabsorption. It is specific, simple, noninvasive and inexpensive. By measuring the amount of hydrogen and methane in the breath, we can determine the amount of lactose is sitting in the small intestine.
Is It IBS or Lactose Intolerance?
Although lactose intolerance and irritable bowel syndrome (IBS) yield similar symptoms, they are very different. IBS is a catch-all diagnosis that is made when all other causes of digestive problems have been ruled out, including lactose intolerance.
However, some people with IBS can have recurring diarrhea that damages the microvilli, leading to lactose intolerance. On the flip side, those with lactose intolerance can have occasional diarrhea. Those with IBS should consult with their doctor to find the best solution for them.
Differences Between a Lactose Intolerance and a Dairy Allergy
While they may feel similar, having a dairy allergy and lactose intolerance are two separate entities. Lactose intolerance is caused by a deficiency of the enzyme lactase. A dairy allergy, however, is an immune response to dairy proteins, such as casein, lactalbumin and whey.
To differentiate between lactose intolerance and a dairy allergy, take a closer look at the symptoms. While lactose intolerance only creates gastrointestinal symptoms, having an allergy to dairy can cause digestive distress as well as reactions in the skin and respiratory systems.
Here are possible skin and respiratory symptoms that may indicate an allergy to dairy:
- Itching or tingling sensation around mouth
- Swelling of lips, tongue and throat
- Coughing or shortness of breath
- Anaphylaxis, a narrowing of airways that may become life-threatening
Dietary supplements are not recommended for dairy allergies but may be effective for lactose intolerance.
Natural Solutions That Help Ease Lactose Intolerance
Studies show that dietary supplements containing the enzyme lactase improve the digestion of lactose.* Some people, however, have trouble digesting dairy because they are allergic to casein, a protein found in dairy products. Therefore, supplements designed to help the digestion of dairy products are not complete unless there are enzymes to address both lactose and casein.
“For those with a dairy intolerance, I recommend taking formulas like Enzymedica’s Dairy Assist or Lacto, which contain enzymes that break down both lactose as well as casein. In addition, Lacto contains lipase to digest the fats in dairy,”* says Dr. Michael Murray, chief science officer of Enzymedica.
Of course, avoiding dairy altogether is the best solution for those with lactose intolerance. But this may be challenging since dairy is such a large part of the Western diet. Also, many foods that don’t fall into the dairy category may contain lactose, so be sure to read food labels closely.
So, relax and let grandpa enjoy his dessert. Whether he outright orders the cheesecake or if lactose is hidden in his pasta sauce, having a high-quality supplement on hand is the best way to ensure that his gut stays healthy and everyone around him stays happy.
- Lactose intolerance - Genetics Home Reference - NIH. (2020, March 31). Retrieved April 10, 2020, from https://ghr.nlm.nih.gov/condition/lactose-intolerance#statistics