Does a rumbling belly after your bedtime glass of milk have you wondering, “Am I lactose intolerant?” It’s a common condition that often develops with age. Fortunately, it’s easy to manage, as long as you recognize the symptoms.
Keep reading to learn about lactose intolerance symptoms and how to manage this common digestive condition.
What Is Lactose Intolerance?
Lactose intolerance means you can’t digest lactose, the natural sugar in milk and dairy products. It happens when your body doesn’t make enough lactase, the enzyme that breaks down lactose. About 36% of people in the U.S. have lactose intolerance.
Most people aren’t born with lactose intolerance. Instead, it starts to develop sometime after infancy, and lactase levels gradually decline as you age. It’s more common if you have a family history or are of these ethnicities:
- African American
- American Indian
- Asian American
“Lactose intolerance is really common and easily treatable with diet modifications and supplementing the lactase enzyme, says Alyssa D’Addezio, MD; Greater Pittsburgh Medical Associates–UPMC.
“This is good news for anyone who loves ice cream or a cup of milk but have always struggled with the upset stomach and diarrhea that accompany it. If you have any of these symptoms, try eliminating lactose in your diet and track your symptoms for a few weeks to see if it helps,” adds Dr. D’Addezio.
Lactose intolerance is a food intolerance, not an allergy. With an allergy, your body’s immune system thinks a protein in certain foods is harmful, so it fights it. Lactose intolerance doesn’t involve an immune response.
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Lactose Intolerance Symptoms
In normal digestion, your body produces plenty of lactase enzyme. It breaks down lactose in your small intestine so that you can absorb it into your blood. But without adequate lactase, undigested lactose remains in your small intestine and then travels to your large intestine (colon).
As it moves along your digestive tract, undigested lactose draws water into your intestines. Once it reaches your colon, bacteria break down lactose by fermenting it. In doing so, they produce gas.
That extra water and gas in your large intestine cause these lactose intolerance symptoms:
- Gas and bloating.
- Rumbling sounds in your belly.
- Belly pain or cramping.
- Nausea or vomiting.
Lactose intolerance symptoms may start within 30 minutes to two hours after eating or drinking anything with milk. The severity of symptoms varies among people, depending on how much lactase your body produces. Most people can digest some amount of lactose.
High Lactose Foods to Avoid
Lactose is in all milk and dairy foods. If you think you may have lactose intolerance, eliminate these foods for a few days and see if your symptoms improve:
- Cow’s milk, goat’s milk, or any beverages, like smoothies, made with dairy milk.
- Milk powder.
- Cream and whipped cream.
- Ice cream.
- Pudding or custard.
- Milk chocolate.
- Whey protein powder or supplements.
Milk is sometimes a hidden ingredient in packaged foods, so check food ingredient labels. You’ll probably find milk or milk products in these items:
- Baked goods like pancakes, muffins, quick bread, or mixes to make these.
- Processed foods like cream soups, instant potatoes, or mac and cheese.
- Hot dogs and deli meats.
- Protein bars or drinks.
What to Eat When You’re Lactose Intolerant
Even though dairy foods might be off-limits, there are still plenty of other foods to choose from when you have lactose intolerance. You can fill your plate with:
- Fresh or frozen fruits without cream sauces.
- Fresh or frozen vegetables without cream or cheese.
- Plain whole grains like oats, brown rice, or quinoa.
- Nuts, seeds, and plain nut butter.
- Meat, poultry, or fish without cream or cheese sauces.
- Non-dairy plant milk, yogurt, or cheese.
Many non-dairy foods are high in calcium. Adding these into your diet can help replace dairy calcium:
- Calcium-fortified orange juice.
- Fortified breakfast cereals.
- Canned salmon or sardines.
- Bok choy.
- Canned pinto beans.
Besides these naturally lactose-free foods, several dairy foods are low in lactose and might be safe in small portions:
- Hard cheese, like aged cheddar, Swiss, or Parmesan.
- Kefir (probiotic-rich milk).
- Cottage cheese.
- Sour cream.
Since lactose intolerance isn’t an allergy, you don’t have to strictly avoid lactose. If small amounts of dairy or milk-containing foods don’t bother you, it’s OK to eat them.
Is There a Treatment for Lactose Intolerance?
There is no permanent way to reverse lactose intolerance due to a lactase deficiency. You can manage the symptoms by avoiding lactose-rich foods. You can also take supplemental lactase enzymes to replace the lactase your body doesn’t make.
You can buy lactase supplements at any drug store. They come as drops you add to your milk or pills you take just before eating or drinking dairy. Many dairy manufacturers also make lactose-free milk and dairy products by adding lactase directly to the food.
If you have questions about managing lactose intolerance, contact a registered dietitian. They can educate you on which foods to limit and how to plan a lactose-free or low-lactose diet.
The UPMC Adult Congenital Heart Disease (ACHD) Center is a joint program between UPMC Children’s Hospital of Pittsburgh and UPMC Heart and Vascular Institute. We provide long-term care for adolescents, young adults, maternal patients, and adults with congenital heart disease. Our goal is to provide complete care from your childhood all the way through your life. Our team of experts has a wide knowledge of heart conditions.