What is lactose intolerance?

Everything you want to know about this common complaint

You eat a piece of milk chocolate or enjoy a creamy pasta, and a few hours later it starts: bloating, flatulence, rumbling in your belly or even diarrhea. Where's the toilet! Sound familiar? Then chances are you've heard of lactose intolerance.

But what exactly is it? And how do you know if you have it? In this blog, we explain it to you step by step.

What is lactose?

Lactose is the natural lactose found in milk from mammals, such as cows, goats and humans. You find it not only in milk itself, but also in products such as:

• cheese (especially soft cheeses)
• yogurt and cottage cheese
• cream, butter, whipped cream
• milk chocolate
• ready-made sauces, soups and cookies

Lactose is made up of two smaller sugars: glucose and galactose. To absorb them properly into your body, your body has come up with something clever: the enzyme: lactase.

What does lactase do?

Lactase is an enzyme produced in your small intestine. You can think of it as scissors made specifically to cut through lactose. This way your body can absorb the loose sugars into your blood. No lactase = no cut = lactose stays whole and passes through to your colon. And that's where the trouble starts.

Read more here: What does lactase do?

When lactose enters your colon undigested, intestinal bacteria go to work on it. This is called fermentation. This produces gases and acids that cause:

• flatulence
• abdominal pain
• cramps
• bloating
• occasional diarrhea

So what exactly is lactose intolerance?

At lactose intolerance your body makes (too) little lactase. As a result, you can't digest lactose properly and develop symptoms after eating dairy products.

It is not an allergy. Your immune system is not doing anything wrong. It's a digestive problem. Your body simply lacks the tools to break down lactose. A carpenter doesn't get very far without a hammer either.

Also read: Why your tummy might say 'no' to cow's milk

Different forms of lactose intolerance

Primary lactose intolerance

This is the most common form. You are born with lactase, but as you age, your body makes less of it. Result: gradually more symptoms after dairy. This is a natural process and is common worldwide.

Secondary lactose intolerance

In this case, the intestinal wall is temporarily damaged, for example by celiac disease (gluten intolerance), a stomach flu, a parasitic infection, a course of antibiotics or an intestinal condition such as Crohn's disease. The good news: as the gut recovers, lactase production can often increase again.

Congenital lactose intolerance

This form is very rare and genetic. Babies are completely missing the enzyme lactase from birth and react violently to breast or artificial cow's milk-based formula. It is usually discovered shortly after birth.

How do you know if you are lactose intolerant?

Symptoms vary from person to person. Some get an immediate stomach ache from a dash of milk, others can eat yogurt just fine but not cream pie. Common symptoms are:

• Bloating: as if your belly is suddenly full of air.
• Flatulence: more gas than normal, often with an unpleasant odor.
• Abdominal cramps: pulling or stabbing pain in the lower abdomen.
• Diarrhea or soft stools: sometimes immediately, sometimes not until the next day.
• Nausea: especially with larger amounts of lactose.

Note that these symptoms can also occur with other conditions, such as irritable bowel syndrome (PDS). Therefore, it is important to observe carefully and test if necessary. Always consult with a doctor or dietitian if you have symptoms.

What can you do for lactose intolerance?

The good news: lactose intolerance is often manageable. It takes extra vigilance, learning what foods are made of and listening to your body. But you don't have to live 100% dairy-free. Make adjustments based on what suits you and you'll go a long way that way. Consider:

• Lactose-free dairy: there is a wide range of lactose-free milk, yogurt, cream, whipped cream, and so on these days.
• Lactase pills: take these enzymes just before a meal containing lactose. Works well for many people, especially with occasional use.
• Plant-based alternatives: oat milk, soy milk, almond milk and coconut milk are generally lactose-free.
• Hard cheeses: such as Parmesan, aged Gouda or cheddar contain hardly any lactose.
• Reading labels: note terms such as milk powder, whey powder, cream, lactose, milk protein.

Read more here: Which cheeses are high in lactose or low in lactose?

Living with lactose intolerance: takes some getting used to, but doable

At first, it can be overwhelming. All of a sudden you have to read labels, look for alternatives and give explanations at birthdays. But you'll find that you get used to it. Really.

What is lactose intolerance and what happens in your intestines

Lactose intolerance means that your body does not have enough lactase produces. That enzyme breaks down lactose off into smaller sugars. If this fails, lactose enters the colon undigested. There, bacteria convert it into gas and acids, which can cause flatulence, cramps, bloating and sometimes diarrhea.

What is lactose and what products does it come in

Lactose is a natural lactose which is found in milk from mammals. You can find it in milk, as well as in products such as yogurt, quark, room, soft cheeses, butter, whipped cream, milk chocolate and in some cookies, soups and ready-made sauces. On labels, lactose may also appear as milk powder, whey powder, room or milk protein.

What does the enzyme lactase do?

Lactase is an enzyme in the small intestine. It cuts lactose into glucose and galactose. These smaller sugars, however, your body can absorb and use as a source of energy.

What symptoms belong to lactose intolerance

Common complaints are a bloated belly, flatulence, cramps, diarrhea or soft stools and sometimes nausea. These symptoms can also occur with other conditions, so when in doubt, consult with a doctor or dietitian.

What forms of lactose intolerance are there

There are three forms: primary lactose intolerance in which the production of lactase gradually decreases, secondary lactose intolerance which results from damage to the intestinal wall and is usually temporary, and the rare congenital lactose intolerance which is present from birth.

How do I know if I am lactose intolerant

Watch your pattern of complaints after eating or drinking dairy products and discuss this with a doctor or dietician. In some people, small amounts cause symptoms, while others tolerate some dairy such as yogurt.

How is lactose intolerance diagnosed

Diagnosis can be made in several ways: with a elimination diet in which lactose is temporarily avoided and then reintroduced, with a hydrogen breath test that measures gas formation, or with a lactose tolerance test in which blood sugar is measured after drinking lactose.

What can you eat for lactose intolerance

You can choose lactose-free dairy such as milk, yogurt or cream. Hard ripened cheeses such as Parmesan or aged Gouda are usually low in lactose. In addition, many plant-based alternatives such as soy, oat, almond or coconut drinks.

Do lactase pills help and when to use them

Lactase supplements you can take right before a meal containing lactose. They help many people tolerate occasional dairy, such as when eating out or if you are not sure if there is lactose in a dish.

Is lactose intolerance the same as an allergy

No. Lactose intolerance is a digestive problem due to a deficiency of lactase. In an allergy, the immune system on a protein. So those are two different things.

You don't have to be an expert

Lactose intolerance means your body has trouble digesting milk sugar. This is due to a deficiency of the enzyme lactase. Complaints range from flatulence to abdominal pain and diarrhea. Fortunately, there are plenty of solutions: from lactose-free products to convenient enzyme pills and plant-based alternatives.

You don't need to be an expert to deal with it, you just need to listen carefully to your own body.

On NooMooo you will find tips, explanations and experiences that will help you along. Without fuss, with practical information. So that you can enjoy what you can tolerate.