Not feeling well after eating ice cream?
Have you ever felt sick after eating a piece of cheese or a bowl of ice cream? If you experience stomach discomfort after consuming your favorite dairy treat, you may have a lactose intolerance.
As you get older, your body has a more difficult time digesting lactose, a natural sugar found in dairy products.
“People can develop a lactose intolerance at any age, but it’s most common to develop it in adolescence or adulthood,” says Dr. Michael D’Astice, a gastroenterologist at Advocate Health Care. “It often develops gradually, even if you’ve never had problems eating dairy before. A lot of people don’t notice symptoms until they’re in their 30s or 40s.”
A lactose intolerance happens when your small intestine doesn’t make enough of the enzyme lactase, which your body uses to break down lactose. Without enough lactase, the lactose moves into your colon, where it’s broken down by bacteria. This can cause symptoms such as bloating, gas, diarrhea, nausea and abdominal cramping within 30 minutes to a couple of hours after eating or drinking something containing lactose.
The amount of lactose you consume and how much your body can handle can affect the severity of your symptom. Some people can tolerate small amounts of dairy, while others experience discomfort even with minimal exposure.
A lactose intolerance is not a dairy allergy
While both a lactose intolerance and an allergy are reactions to dairy, they affect the body in different ways. For starters, a lactose intolerance is a digestive issue, whereas a dairy allergy involves your immune system.
While uncomfortable, a lactose intolerance is not dangerous or life threatening.
In people with dairy allergies, their immune system mistakes whey and casein – proteins found in milk – as harmful. This causes an allergic reaction that can include hives, vomiting, swelling, trouble breathing or even life-threatening anaphylaxis.
“If someone has a milk allergy, even small amounts of milk can cause a serious reaction,” Dr. D’Astice explains. “If they’re lactose intolerant, they may still tolerate small amounts of dairy or use lactase supplements without risk.”
How a lactose intolerance is diagnosed
Most of the time, a lactose intolerance is diagnosed through a physical exam and based on your symptoms, medical history and dietary habits. Your doctor will likely ask about:
- What you typically eat and drink
- When your symptoms occur
- Whether symptoms improve when you avoid dairy
- Your family history of digestive issues
They may run tests to rule out other conditions, such as celiac disease or irritable bowel syndrome, which can cause similar symptoms.
If the diagnosis isn’t clear, your provider may recommend a test that measures how your body responds to lactose, but it’s not necessary for most lactose intolerance diagnoses.
Managing a lactose intolerance
Many people successfully manage the condition by making a few lifestyle changes, such as limiting dairy foods like milk, ice cream and cheese. Other ways you can manage a lactose intolerance, include:
- Trying lactose-free alternatives: Many grocery stores carry lactose-free milk, yogurt and cheese.
- Use lactase supplements: These over-the-counter pills or drops can help break down lactose during meals.
- Experiment with low-lactose dairy: Hard cheeses, such as cheddar and Swiss, and yogurts with live cultures, are often easier to digest for people with a lactose intolerance.
It’s also important to get enough calcium and vitamin D if you are cutting back on dairy. Good non-dairy sources include leafy greens, almonds, plant-based milks and canned fish with bones, such as salmon or sardines.
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