Lactose intolerance

Lactose intolerance

Lactose intolerance is caused by the body not being able to break down milk sugar (lactose). This can cause abdominal pain, diarrhea and bloating. Lactose intolerance is not the same as milk allergy, although both cause symptoms after consuming milk, and it is important to distinguish between these conditions.

What is lactose?

Milk and milk products contain milk sugar, or lactose, which is a disaccharide consisting of glucose and galactose. It therefore consists of two other sugar molecules. Glucose and galactose are called monosaccharides. Mono means one, and di means two. Saccharides are a type of carbohydrate. To be able to digest lactose, the body must break it down into smaller parts, into the monosaccharides. The body does this with the help of the enzyme lactase.

What is lactase?

The enzyme lactase is normally found in all people from birth, and is used to break down the lactose found in breast milk. Lactase acts as a kind of scissors that cut up the lactose in the intestine, so that the smaller components (monosaccharides) can be absorbed into the body. But after toddlerhood, the activity of lactase naturally decreases. Many people, especially around the equator, have little or no lactase activity as adults and are therefore unable to break down milk sugar. Some people have a mutation in the gene that controls lactase production, which means that production continues throughout life.

What is lactose intolerance?

Lactose intolerance is not an allergy, but an intolerance to lactose (milk sugar). Lactose intolerance is not dangerous.

About 2-3% in Norway have lactose intolerance. Worldwide, the incidence is much higher, approx. 80%. It is highest in population groups originating from Africa, Asia and South America.

Those with lactose intolerance have too little of the enzyme lactase. This leads to the body not being able to break down milk sugar, which in turn leads to problems in the stomach and intestines and often pain. Lactose intolerance can also occur temporarily in connection with celiac disease, or after an acute stomach infection.

Other terms used for the condition lactose intolerance are:

• Milk intolerance

• Lactose intolerance

• Lactase deficiency

• Lactose malabsorption

Lactose intolerance or milk allergy?

Both lactose intolerance and milk allergy can cause reactions when you drink milk or consume other milk products, and it can often be difficult to distinguish between the two conditions. Milk allergy is an allergic reaction to milk proteins or milk peptides, and can cause anything from mild to severe allergic reactions. Both conditions can cause pain in the stomach and diarrhoea, but with a milk allergy, milk products must be avoided completely, and it is a more serious condition than lactose intolerance.

Symptoms of lactose intolerance

In most people, lactose intolerance causes no or negligible symptoms. Symptoms can occur between 15 minutes to 6 hours after consuming milk, which can make it difficult to link it to the milk intake. The threshold for how much milk and milk products one can tolerate is also very individual, so consumption of milk products will sometimes cause symptoms, and other times not. Complaints in connection with lactose intolerance usually only occur after the age of 10-12, and are not common in young children, as lactase activity gradually decreases.

These can be symptoms of lactose intolerance:

• Watery diarrhea

• Belching

• Rumbling in the stomach

• Bloating

• Flatulence / flatulence

• Pain in the stomach/intestines

Both nausea and vomiting can also occur, but are more rare.

How do you know if you have lactose intolerance?

If you have symptoms of lactose intolerance, you should experience improvement by avoiding products containing this for approx. 2 weeks. You can then introduce lactose into the diet again, and if the symptoms return after 1-2 days, this may be a signal of lactose intolerance. Such tests should be carried out in consultation with a doctor or nutritionist. There is also a genetic test that examines whether you have a predisposition to develop lactose intolerance, and a breath test. But these tests are not completely certain, and can both show lactose intolerance in someone who doesn't really have it, and vice versa.

Treatment for lactose intolerance?

The most important treatment is to avoid products with lactose.

Most people with lactose intolerance tolerate some lactose, and do not react until they ingest a certain amount. It is wise to find your own limit for how much lactose you can tolerate before symptoms arise, and limit your intake accordingly.

There are also several products at the pharmacy that can help break down the lactose (milk sugar) in various foods when ingested, which can be taken in conjunction with meals that contain or are suspected of containing lactose. They work by adding the enzyme lactase, which is the enzyme the body lacks to be able to break down lactose.

Alternatives to products containing lactose

Today there are many alternatives to cow's milk and dairy products, such as plant-based milk, sour cream and yoghurt. Lactose-free or lactose-reduced cow's milk products can also be found in the shops. Here, the milk sugar has already been broken down, so that this does not need to be done in the body. These products may taste slightly sweeter than regular dairy products.

In general, there is little lactose in products such as butter and in hard white cheeses.

If you avoid dairy products completely, it is important to ensure the intake of calcium and vitamin D in other ways, especially in children.