Lactose intolerance means your body doesn’t make enough lactase, the enzyme that digests the sugar in milk. It is extremely common worldwide, especially in people of African, Asian and Middle Eastern descent. It is uncomfortable but not dangerous, and most people can still enjoy some dairy.
Imagine blaming the canteen food for years of afternoon bloating, when the culprit was the milky tea you drink on every break. Once you know, a simple swap can end the discomfort.
Symptoms
Symptoms usually start between 30 minutes and 2 hours after eating or drinking dairy:
- Bloating and wind
- Diarrhoea
- Tummy cramps and rumbling
- Feeling sick
Lactose intolerance or milk allergy?
They are different. Milk allergy is an immune reaction, more common in babies and young children, that can cause hives, swelling, vomiting and sometimes breathing problems. Lactose intolerance is a digestive problem and does not cause allergic reactions.
How it is diagnosed
A doctor may suggest cutting out lactose for a couple of weeks to see if symptoms improve, then reintroducing it. A hydrogen breath test can confirm it. It is worth getting checked, because similar symptoms can come from coeliac disease or irritable bowel syndrome.
Managing it
- Try lactose-free milk and dairy products
- Many people tolerate small amounts, especially with a meal
- Hard cheeses and yoghurt are often better tolerated than milk
- Lactase drops or tablets taken with dairy can help
- Get calcium from fortified plant milks, tinned fish with bones, tofu, beans and green leafy vegetables
But should I cut out dairy completely?
Usually not. Cutting dairy completely can leave you short of calcium and vitamin D. Most people find a level of dairy they are comfortable with. If you do cut it out, ask a dietitian or pharmacist about replacing those nutrients.
Your next step: Keep a two-week food and symptom diary, then try lactose-free milk for a week and see what changes. If you have weight loss, blood in your poo or ongoing diarrhoea, see a doctor.
Sources: NHS, “Lactose intolerance”; US National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), “Lactose intolerance”. This guide is for general information and does not replace advice from your own nurse, doctor or pharmacist.
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