Lactose is a naturally present sugar found in milk and dairy products. Lactose intolerance is a common condition that manifests as bloating, diarrhoea, increased wind and constipation.
It is estimated that close to 70% of the adult population are intolerant to a degree due to an absence or deficiency in the lactase enzyme. This enzyme breaks down lactose into two simple sugars called galactose and glucose, absorbed into the intestine. Without this enzyme, lactose cannot split into these simple sugars and so cannot absorb and instead ferments, manifesting in the symptoms described.
Getting tested
While lactose intolerance is not a serious condition, the symptoms can mimic other health issues such as gluten intolerance and irritable bowel syndrome. Consequently, seeking a diagnostic test for lactose intolerance is useful for ascertaining how best to deal with your symptoms. While removing lactose and gluten may work, removing both might not be necessary.
The most often used test is the hydrogen breath test, which is non-invasive and allows medics to detect any hydrogen you breathe out into the air after taking in lactose. The principle behind this test is simple. If the sugars are not absorbed and begin to ferment, it will produce hydrogen that can only partially be absorbed in the colon, and so the rest is aspirated as we breathe.
The test works by comparing the amount of hydrogen before and after taking in a solution containing a certain lactose concentration.
When the diagnosis is confirmed
If you are discerned to have lactose intolerance, you can eliminate the symptoms by going on a lactose-free or low-lactose diet. It might be that you can tolerate some lactose, while others might not be able to take in any – it all depends on the level of enzyme in your body.
If you are lactose intolerant, you should avoid the following products:
– Milk: there are many lactose-free milk alternatives if the idea of giving up milk is too much. You can also replace it with drinks made from soy, rice, coconut, or oats. Most of these alternatives only contain a very small amount of lactose and are mostly well-tolerated by most people.
– Cheese: Cheese is derived from milk, and so contains lactose. The amount of lactose varies by cheese, and the softer the cheese, the more lactose is likely to present, so the levels of lactose in cheeses such as Brie and Camembert are naturally higher. You will be fine if you go for 36 months aged parmesan, as the cheese will be naturally lactose-free.
– Bread and baked products: read the label carefully when buying from the bakery aisle. Products added to bread can contain lactose.
– Breakfasts cereals: again, pay attention to the label, as cereals often contain lactose.
– Pre-cooked meats/ sausages: while there are products that will display lactose-free, any without this label probably contains some. The good news for sausage lovers is that you can ask for lactose-free sausages at the meat counter.
– Various frozen foods: again, check the label.
A lactose-free diet
Avoiding all lactose can be difficult and may be present in foods we would never suspect. If we eat onions, broccoli, eggs, and pears, we may be consuming lactose. Equally, some prescribed medications and food supplements have lactose included.
Therefore, even if you have decided to go onto a low-lactose diet, you may want to avoid lactose in foods that are most frequently present. Thanks to the wealth of lactose-free products out there, you can live this way without having to make massive sacrifices.
If you struggle too much with your diet and continue to suffer the symptoms, your doctor may advise you to see a dietician. A dietician will guide you in eating a well-balanced diet that will offer you respite from the unpleasantness of gastric problems.
