(1) Hi Alice,

For some years I did not drink milk, but started to take a lot of milk just recently and discovered I cannot digest milk without developing a lot of gas, stomach aches, etc. I did not have that problem before I stopped drinking milk. Will I develop more lactase, i.e., the ability to digest milk, as time goes on and I drink more milk, or will I have to take Lactaid milk for the rest of my life (it's not available in some countries).

(2) Dear Alice,

What are the symptoms of lactose intolerance (i.e., how long after taking a milk product will symptoms generally begin, and what are the typical symptoms), and how do they differ from irritable bowel syndrome?


Dear Readers One and Two,

Lactose intolerance is a very common condition in which lactose, a sugar found in milk and dairy products, cannot be completely digested. This dairy dilemma — not to be confused with a milk allergy — can occur when a person has a lactase deficiency, which makes it more difficult to digest lactose. Whatever lactose remains undigested moves into the intestines (the colon to be exact), where the bacteria breaks down the undigested lactose and creates fluid and gas in the process. This may lead to some common symptoms of lactose intolerance (abdominal pain, bloating, gas, nausea, and cramps) and usually occurs 30 minutes to two hours after ingesting a lactose-containing product.

Reader One, generally speaking, people produce less lactose as they age — that is, people become less and less able to break down lactose as they grow older. This may explain why you are now experiencing these symptoms. But don’t worry, you’re not alone in this: most American adults have some degree of lactose intolerance by age 20.

Reader Two, although lactose intolerance shares some symptoms of irritable bowel syndrome (IBS), they are two different conditions and are managed in different ways. Read on for more information about lactose intolerance and options.

When it comes to causes, there are three kinds of lactase deficiency that might lead to lactose intolerance:

  • Primary lactase deficiency is the most common type. Folks with this type start off life producing plenty of lactase, but it decreases overtime; they may not experience symptoms of lactose intolerance until early adulthood.
  • Secondary lactase deficiency occurs when there is an injury to the small intestine, and lactose intolerance may improve if the underlying injury is treated.
  • Congenital lactase deficiency is a very rare type that happens when the small intestine produces very little or no lactase at all from the time you're born.

So, how do you know if you are lactose intolerant? It might help to chat with a health care provider. If your stomach is revolting every time you eat dairy products, your provider may suspect lactose intolerance and conduct a lactose tolerance test or a hydrogen breath test to confirm their suspicions.

Unfortunately, when it comes to options or dealing with lactose intolerance, there’s no known cure or way to prevent it (as a natural part ageing the body produces less lactase). But fear not! There are things you can do to minimize the symptoms. There are lactase enzymes (taken as tablets and drops) that may reduce the chances of developing digestive symptoms. It's recommended you check with a health care provider before using these products because some folks — such as young children and pregnant and breastfeeding women — may not be able to use them. Also, keep in mind that not everyone finds these products helpful and even without the help of lactase enzyme supplements, most lactose intolerant people can handle some lactose in their diet without any symptoms. Other ways to minimize lactose intolerance symptoms include:

  • Consuming smaller servings of dairy, especially at mealtimes when food slows down digestion.
  • Trying out different types of dairy products because not all contain the same amount of lactose (for example, certain hard cheeses and yogurt may cause fewer problems).
  • Giving lactose-reduced or lactose-free products a try.
  • Taste-testing different nondairy cheeses, milks, and yogurts made from different sources (such as soy, rice, almonds, coconuts, etc.).

Of course, the only way to avoid lactose intolerance symptoms completely is avoid any foods containing lactose. It can be tricky because some nondairy foods, such as breads, cereals, snacks, salad dressings, and cake mixes, also contain lactose. You could read food labels to check for lactose-containing ingredients, such as milk, milk solids, whey (milk liquid), and casein (milk protein). Additionally, some prescription and over-the-counter drugs and nutritional supplements contain lactose, so you might want to talk with your health care provider or your pharmacist for more information before taking any new medications or supplements.

Finally, if you're experiencing lactose intolerance, it can be helpful to keep your eye on what you eat to ensure you're meeting your daily calcium and vitamin D needs. You could also talk with a registered dietician to get more information about your nutrition needs. If you'd like even more information on lactose intolerance, consider checking out the National Institute of Diabetes and Digestive and Kidney Diseases.


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