Lactose Intolerance: symptoms and alternatives

22nd February 2019
Lactose intolerance can be mild or severe. Although, this depends on the amount of lactose present in a person's diet and how the body can assimilate it.

Lactose intolerance is when the body can’t assimilate lactose, which is a naturally occurring sugar, found in milk. The deficiency of an enzyme called lactase is the cause of this intolerance. This enzyme is responsible for separating lactose into two simple sugars during digestion.

Symptoms of lactose intolerance

Here’s a list of the symptoms you may experience (after ingesting lactose) if you are intolerant. You will notice these symptoms between thirty minutes and two hours after consuming foods containing lactose.

-Nausea. The sensation of discomfort in the stomach that occurs before vomiting.

Abdominal bloating

-Stomach pain

Lactose can cause nausea and abdominal pain.

-Abdominal distension: an increase in the volume of the abdomen.

-Borborygmus (abdominal sounds): are the sounds generated by the movement of gases through the intestines.

-Gases: air in the digestive tract.

-Diarrhea: intestinal alteration characterized by an increase in frequency, fluidity, and volume of bowel movements.

-Feces with a foul odor.

Weight loss.

In some cases, constipation may also occur. This is due to a decrease in bowel movements as a result of methane-producing bacteria.

Causes of lactase deficiency

Lactase deficiency can be primary when the individual is born with a propensity to have it, or secondary when people develop lactose intolerance during their life due to an intestinal problem.

On rare occasions, lactose intolerance may already be present during the first months of life. This is due to a genetic defect that causes the patient not to produce any lactase. Therefore, the infant is intolerant to milk and needs to feed on special lactose-free formulas.

Secondary lactose intolerance occurs when diseases are present before or after intestinal surgery. Examples of diseases that cause lactase deficiency are:

  • Celiac disease
  • Crohn’s disease
  • Diarrhea caused by viral gastroenteritis
  • Giardiasis
  • Advanced diabetes mellitus
  • Chemotherapy
  • AIDS
Lactase deficiency can be primary or secondary.

Diagnosis of lactose intolerance

In general, the diagnosis of lactose intolerance is made clinically and is based solely on the patient’s clinical history and symptoms. However, if the doctor believes it’s necessary to confirm the diagnosis with complementary examinations, two tests are the most common:

1- Respiratory test to investigate the elimination of hydrogen

Patients with intolerance to this component produce large amounts of hydrogen in the colon and we usually eliminate small amounts of it through the lungs. For that reason, this test consists of investigating hydrogen in the air that is exhaled after consuming lactose.

2- Lactose tolerance test

After ingesting this component, we can measure glucose levels to verify if there’s an elevation in the blood levels. In healthy people, lactose breaks down into glucose and galactose; subsequently, the intestine reabsorbs them and releases them into the bloodstream.

However, in patients with lactase deficiency, this component isn’t digested and the glucose contained within is not absorbed. Thus, the elevation of glucose in the blood is discrete in these patients.

Intolerance alternatives

The ideal alternatives should be lactose-free milk with sufficient nutritional value, and low allergenicity, that tastes good.

There are many lactose-free options in the market.

Protein hydrolysates

This is generated through heat or hydrolysis of the original protein in cow’s milk. The nutritional value is adequate and the flavor is good which is ideal for intolerances and chronic diarrhea.

  • Milk with high hydrolysates:
    Casein
    Serum
    Soybean + pork collagen
  • Low hydrolyzed milk
    Serum
    Serum + casein

Soy options

These are composed of soy proteins containing vegetable oils and carbohydrates.

The soy options that are ideal for people who are allergic to proteins in cow’s milk are:

  • Corn
  • Starch
  • Saccharose
  • Dextrinomaltose
  • Glucose polymers

Finally, if you suffer from any of the symptoms that we discussed previously, don’t hesitate to consult with your doctor. Choose other milk alternatives if you have an intolerance. Also, remember that as time goes by, you can gradually try to ingest lactose again until it’s tolerable.