- Barrett's Esophagus
- Celiac Disease
- Colon Cancer
- Crohn's Disease
- Diverticular Disease
- E. coli Infections/Traveler's Diarrhea
- Esophageal Cancer
- Inflammatory Bowel Disease (IBD)
- Irritable Bowel Syndrome (IBS)
- Lactose Intolerance
- Peptic Ulcers
- Ulcerative Colitis
Lactose is the sugar in milk products. Individuals who are lactose intolerant lack the enzyme or chemical (lactase) to break down this sugar for absorption. As a result, lactose gets into the large bowel (colon) and may cause gas, bloating, diarrhea and abdominal cramping. Sometimes lactose intolerance occurs after digestive infections.
Lactose intolerance affects more than 7 million Canadians. This is likely an underestimate as many individuals do not associate their symptoms with lactose-containing foods or do not experience symptoms.
Understanding Lactose Intolerance
Lactose is the sugar in milk products. Individuals who are lactose intolerant lack the enzyme or chemical (lactase) to break down this sugar for absorption. As a result, lactose gets into the large bowel (colon) and may cause gas, bloating, diarrhea and abdominal cramping.► View Guide
The simplest, and probably most reliable, way of diagnosing lactose intolerance is to remove all lactose products from your diet for 1 - 2 weeks and see if your symptoms disappear. If the symptoms do disappear, a diet that does not include lactose should be maintained.
There are other tests available when the response to lactose exclusion is not clear. These include blood tests, hydrogen breath test and stool acidity test for young children.
The symptoms of lactose intolerance may include:
- Abdominal discomfort, especially related to consumption of milk and milk products
- Bloating, gas, cramps
- Cessation of symptoms when milk and milk products are removed from diet
Living With Lactose Intolerance
There are now lactase enzyme products that you can now purchase to help your body digest lactose. These can be purchased at your local pharmacy without a prescription. Lactose-reduced milk and milk-products are also now available at most grocery stores.
Managing Your Symptoms
If a person is lactose intolerant, the best treatment is to avoid dairy products. It is not possible to change how much lactase our bodies produce but there are strategies you may be able to use to increase your tolerance to lactose such as introducing small amount of milk and milk products until you notice your symptoms worsening or by combining your intake with other foods. Many people with lactose intolerance will be able to enjoy milk, ice cream and other dairy products if taken in small amounts or with other food. Hard cheeses and yogurt may be tolerated better than other dairy products.
There are lactase enzymes available both in the pharmacy and health food stores which help minimize the effects of lactose intolerance. The commercially-produced, lactose-reduced milks are usually quite reliable and are well tolerated, as are milk substitutes such as rice milk or soya milk.
Milk products are the primary sources of calcium and vitamin D. Anyone who avoids milk products should take calcium and vitamin D supplementation assuming an otherwise normal diet. Depending on your age, the recommended daily intake of calcium can range from about 200 mg in infants to 1,300 mg for children and adults.
Frequently Asked Questions
I have stopped eating milk, cheese and ice cream but still have symptoms sometimes. Why is that?
The reason could be that you are still unknowingly ingesting milk products. Milk and milk products are often added to processed food. Products that list whey, dry milk solids, dry milk powder, whey, curds contain lactose. Be sure to check the ingredients on food labels to see if there is lactose in food products that are not obviously milk-based.
If my child is lactose intolerant, what can he eat to be sure he gets calcium in his diet?
Non-milk products that contain calcium include rhubarb, spinach, broccoli, salmon, sardines, soy milk and oranges among others. It is a good idea to speak with a nutritionist or dietitian if you or someone in your home is lactose intolerant.
Is it possible that I have celiac disease as well as lactose intolerance?
It is possible. 25% of patients who have been clinically identified as lactose intolerant, have celiac disease. In Canada, that means about 73,500 people have undiagnosed celiac disease which is the causal agent for their lactose intolerance. If you think you have celiac disease, you should speak with your doctor.
Is lactose intolerance the same thing as being allergic to milk?
No. When people are allergic to milk, their body’s immune system reacts to one or more milk proteins. Milk allergies can be life threatening even if a small amount of milk or milk product is consumed. Milk allergies are generally diagnosed in the first year of life, while lactose intolerance occurs more often in adulthood.
Lactose is the sugar in milk products. Individuals who are lactose intolerant lack the enzyme or chemical (lactase) to break down this sugar for absorption. Lactose then gets into the large bowel (colon) and may cause gas, bloating, diarrhea and abdominal cramping. Sometimes lactose intolerance occurs after digestive infections.
Lactose intolerance affects more than 7 million Canadians. This is likely an underestimate as many individuals do not associate their symptoms with lactose-containing foods or are asymptomatic.
For individuals who seek medical attention for their symptoms, physicians only submit 10% for clinical testing specifically for lactose intolerance. Since only 10% of symptomatic patients are clinically tested (294,000 people), it appears that Canadian physicians underestimate the daily impact of chronic lactose intolerance symptoms.
25% of patients, clinically identified as lactose intolerant, have celiac disease. In Canada, that means 73,500 people have undiagnosed celiac disease which is the causal agent for their lactose intolerance.
A digestive disease patient may consume 10 g or more of lactose each day from their drugs.
Lactose intolerant people who use a lactase containing product will spend over $500 per year. These costs are not covered by insurance plans as the product is sold over-the-counter.
Lactose intolerant people who avoid dairy products should be taking calcium supplements. The recommended daily intake of calcium is 1,000 mg for adults and 1,300 mg for those over the age of 50 years. The annual cost per person taking 750 mg calcium per day ranges from $50 to $75. Again, these costs are not covered by insurance plans as products are sold over-the-counter.