Check-up

Lactose intolerance

What is meant by lactose intolerance?

Lactose intolerance is the body’s inability to digest lactose – a sugar found in milk and other dairy products.

It happens when the small intestine does not make enough of an enzyme called lactase. Babies and young children produce lactase in order to digest breast and other milk. However, as the child gets older, its body ceases to produce this enzyme. Lactose intolerance can begin at different times in life and may be seen in premature babies.

Children who were born at full term generally do not show signs of lactose intolerance until they are at least three years old.

Lactase deficiency occurs as a result of not having enough lactase and may be caused by intestinal diseases such as coeliac disease and gastroenteritis. It can also arise after bowel surgery.

Lactase deficiency can develop temporarily as a result of viral and bacterial infections, especially in children, when the cells lining the intestine are damaged.

What are the symptoms?

Symptoms can vary from person to person but may include abdominal bloating, tummy cramps, diarrhoea and flatulence. Stools may be foul smelling or may float. Weight loss can also occur and slow growth may be noticed.

Symptoms usually occur after consuming milk products, large doses of which may cause an increased reaction. While some of those affected can tolerate two to four ounces of milk at one time, larger servings may cause problems.

Should I cut out all milk and diary products if I think I have lactose intolerance?

Removing milk products from the diet may improve symptoms. However, not consuming milk can lead to a shortage of vitamin D, calcium, riboflavin, and protein.

It is therefore very important to include other sources of calcium and vitamins if milk products are removed from the diet.

Some milk products may be easier to digest and include buttermilk and cheeses (they have less lactose than milk), yogurt and goat’s milk products. Lactose-free milk, soy milk or rice milk can also be used.

If you are experiencing any of the above symptoms it is important to see your doctor to confirm the diagnosis.

A referral to a dietitian may be required before restricting milk products, particularly in a child’s diet. They will also be able to advise on other measures to reduce or prevent symptoms.