About Lactose Intolerance - Its Causes, Symptoms and Dietary Management

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Lactose Intolerance - Symptoms:
For any indication of LI to show up it will take anywhere from 30 minutes to two hours after the consumption of milk or milk products. The common signs and symptoms seen are diarrhea, nausea, cramping in the abdomen, bloating, passage of loose, watery stools, gas and excessive flatus. The symptoms are usually mild but can get relentless at times.

There are basically three types of Lactose Intolerance:

Primary lactose intolerance - Decrease in lactase can begin as early as age two in certain individuals, bur normally associated with advancing age, making it more and more difficult to digest milk and milk based products. Premature birth could also lead to LI as lactase enzyme production increases during the third trimester in the fetus.
Secondary lactose intolerance - could be due to any injury, illness or surgery of the small intestine. It can also be due to intestinal diseases like celiac disease, gastroenteritis and an inflammatory bowel disease like Crohn's or even radiation to the abdomen. Though it could take some time treating, the core condition can improve lactase production and alleviate the symptoms.
Congenital lactose intolerance - As the name indicates it could be due to hereditary. In such infants there is a total absence of lactase production or activity. Most worrying, as these kids are intolerant even to the lactose in breast milk too and require lactose free infant formula. Certain ethnic groups like African, Asian, Hispanic and American Indian people are more susceptible than others. Around 6-10%of Americans & Europeans have LI but can go up to 90% in certain ethnic groups in Peru.

If your doctor suspects LI based on the signs and symptoms, s/he might ask you to reduce the quantity of milk and dairy foods in your diet. S/he might also want to confirm by conducting certain tests.

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User Comments

10 November, 2010 | Emma Louise | Reply

How much milk and milk products like cheese, yogurt, cream etc can be consumed by a women with normal weight and no medical conditions. I do not like to consume milk but will not mind only in my cereals. So if I consume one cup of milk in my cereals then how much of milk products can I have in a day.

11 November, 2010 | Poonam | Reply

Hello Emma,
You can consume 2-3 servings of milk/milk products everyday. A serving consists of 8 oz milk or 2/3 cup of low fat yogurt. 1 oz of cheese or 1/4 cup of cottage cheese can also be eaten instead. Cream is a concentrated source of saturated fat and should be used only occasionally or if necessary.

09 November, 2010 | Aditi | Reply

I say buttermilk/yoghurt is the way to go!!! I'm infamous in my family even today, for all the trauma I (as a child) put mom through to drink milk. I wish my first words had been " lactose intolerance" and perhaps I would've been absolved! Never mind that mine is a very specific milk-taste-and-smell intolerance!!! Also, a red flag would be behavioural avoidances like spilling milk very often, pouring it down the drain or outside a balcony (ahem, case in point: yours truly!), tantrums at milk-times, etc. I overcame my dislike with addition of a few drops of coffee to milk - in retrospect, that coffee should ideally have been decaf. If only it were available 25 yrs ago!

08 November, 2010 | Kanika Jain | Reply

Dear Rishabh,
Milk and its products are often added to processed foods.According to The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), following food products may contain lactose(in varying amounts)-

-bread and other baked goods
-waffles, pancakes, biscuits, cookies, and mixes to make them
-processed breakfast foods such as doughnuts, frozen waffles and pancakes, toaster pastries, and sweet rolls
-processed breakfast cereals
-instant potatoes, soups, and breakfast drinks
-potato chips, corn chips, and other processed snacks
-processed meats, such as bacon, sausage, hot dogs, and lunch meats
-margarine
-salad dressings
-liquid and powdered milk-based meal replacements
-protein powders and bars
-candies
-non-dairy liquid and powdered coffee creamers
-non-dairy whipped toppings

08 November, 2010 | Rishabh Gaba | Reply

Are there any other products which may contain lactose?

08 November, 2010 | Shakthi Nene | Reply

My son who is 13 yrs old has stopped drinking milk regularly. He says that he feels a sort of discomfort if he drinks milk. Is this lactose intolerance or he just giving an excuse not to drink milk? He is underweight, catches cold and has chest congestion with slight wheezing more often. Please advise.

09 November, 2010 | Vijayalakshmi Iyengar | Reply

Dear Shakti
In our family many of my nephews and nieces used to cry off milk and would complain of feeling nauseous. Sometimes they even threw up. We substituted milk with thick buttermilk from freshly made curd and gave it as many times as required (equal to the amount of milk). The children grew up strong and healthy.
Many well wishers cautioned us about the children catching a cold or developing sinusitis, but in fact the reverse happened and the children built a good immunity as curd acts as a probiotic.

If your son is complaining I am sure there is some discomfort, try adding some flavouring agent to the milk or substitute with curd and see if it agrees with him. Some paediatricians recommend soy milk, so check with your son’s paediatrian for what is best for him as he does need Calcium for growth.
All the best.

09 November, 2010 | Sangeetha Narayana Swamy | Reply

Dear Shakthi,

If your son has had a episode of diarrhea, then he can show symptoms of temporary lactose intolerance but if he has not been drinking milk for some time then may be he dislikes the smell and taste of milk. You can try giving him flavoured milk, milkshakes, fruit yogurt, buttermilk, lassi etc that are good substitutes for milk in terms of nutrition.

At his age he requires good amount of energy and calcium, so do not to omit milk and milk products completely just because he dislikes them. Be innovative and try spiced lassi, smoothies with berries and fruits etc.

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