Lactose Intolerance Symptoms and Diagnosis Explained

Lactose intolerance is a condition where the body lacks the enzyme lactase needed to digest lactose, the sugar found in milk and dairy products. In India, despite a rich dairy culture, lactose intolerance is prevalent, affecting a significant portion of the population. According to a survey from the Hindustan Times about 60% of the Indian population is lactose intolerant.

Addressing this condition is crucial for overall health as it can lead to digestive discomfort, including bloating and diarrhea. Untreated, it may result in nutrient deficiencies. Recognizing and managing lactose intolerance ensures individuals can enjoy a diverse and balanced diet, fostering improved well-being and quality of life.

What is Lactose Intolerance?

Lactose intolerance is a digestive disorder characterized by the body’s inability to fully break down lactose, a sugar present in milk and dairy products. Lactose digestion relies on the enzyme lactase, which is typically produced in the small intestine. When insufficient lactase is produced, lactose remains undigested, leading to uncomfortable symptoms like bloating, gas, and diarrhea after consuming dairy (1).

Lactose, a disaccharide, must be broken down into its component sugars, glucose and galactose, for absorption. In lactose intolerance, this breakdown is incomplete, resulting in the malabsorption of lactose. This condition is distinct from a milk allergy and is prevalent worldwide, affecting individuals to varying degrees based on genetic and environmental factors.

Types of Lactose Intolerance

• Primary Lactose Intolerance:

This is the most common type and is often genetically determined. Many individuals are born with sufficient lactase enzyme to digest lactose. However, as they age, the production of lactase decreases, leading to lactose intolerance in adulthood. This form is prevalent in certain populations, especially those with Asian, African, or Native American ancestry.

• Secondary Lactose Intolerance:

Unlike primary lactose intolerance, this type is acquired and arises from injury or illness affecting the small intestine. Conditions such as celiac disease, inflammatory bowel diseases (IBD), or infections can damage the intestinal lining, reducing the production of lactase. Once the underlying issue is addressed, lactose tolerance may improve.

Symptoms of Lactose Intolerance

Lactose intolerance can manifest with a range of symptoms, typically occurring within a few hours after consuming lactose-containing foods or beverages. Common symptoms include:

Digestive Discomfort:

• Bloating
• Gas
• Diarrhea
• Stomach cramps or pains

Nausea and, in some cases, Vomiting:

• Feeling queasy after consuming dairy products

General Discomfort:

• A general sense of discomfort or unease

Factors Contributing to Lactose Intolerance

• Dairy Milk like cow and buffalo milk
• Foods rich in dairy like paneer, curd and butter milk
• Whey protein supplements

How to Manage Lactose Intolerant?

• Identify foods that contain lactose

Apart from milk, lactose is found in various dairy products such as cheese, cottage cheese, various mithai, whey protein powders, and soup powders containing milk powder. Additionally, dairy whiteners and skimmed milk powder also contain lactose. Curds might be manageable for some with lactose intolerance since the lactose is converted into lactic acid during the fermentation process. However, tolerance levels are individualized, and it is advisable to experiment cautiously with small portion sizes.

• Choose dairy free milk alternatives

Many milk alternatives, particularly plant-based beverages, offer a suitable option for individuals dealing with lactose intolerance. Plant-based drinks like almond, oat, walnut, and rice-based alternatives also provide excellent choices. These alternatives not only cater to lactose intolerance but bring additional benefits as they are plant-based, cholesterol-free and can be fortified with vitamins and minerals.

• Choose plant-based protein

Plant-based protein supplements are inherently free from lactose, making them a safe option for those who experience discomfort or digestive issues with dairy-derived protein products. Plant-based protein sources often come with additional nutrients and health benefits. For example, many plant-based proteins are rich in fiber, antioxidants, and various vitamins and minerals. For individuals with lactose intolerance, plant-based protein supplements are generally easier to digest.

• Get calcium from other foods

Most Indians meet their calcium requirements through milk or dairy products. But if you are lactose intolerant that might not be an option for you. Other high calcium foods include green leafy vegetables, plant-based drinks, nuts, millets like Amaranth, Ragi, and grains like Quinoa work wonders. Calcium supplements are also a great choice to get the necessary calcium to the body.

• Improve your gut health

Improving your gut health is a good way to increase tolerance to lactose so that the digestive system gets stronger.  Including probiotics and prebiotics in your diet can help to build the flora.

Conclusion

Milk and milk related products have always been part of the Indian diet. People drink milk regularly, put milk in their tea and coffee, make sweets using milk and so many other ways to consume milk and dairy products. People might think that lactose conditions like lactose intolerance might not be common in India due to foods with lactose always being part of our lives. Multiple studies and survey show that around 60% of Indians are lactose intolerant.

Adapting to a diet without milk and other dairy products can be challenging in India but as the awareness about lactose intolerance increases in India so do the food options. There are many non-dairy alternatives to milk, protein supplements, and sweets. Identifying the symptoms of lactose intolerance early is the key to managing lactose intolerance.

FAQs

1. Is lactose intolerance common in India?

Lactose intolerance is relatively common in India, especially among certain ethnic groups. It varies regionally but is estimated to affect a significant portion of the population due to genetic factors.

2. How can I check my lactose intolerance in India?

In India, lactose intolerance can be diagnosed through various methods, including lactose tolerance tests, hydrogen breath tests, or elimination diets, conducted under the guidance of a healthcare professional.

3. What is the Indian remedy for lactose intolerance?

Indian remedies for lactose intolerance include consuming lactase enzyme supplements, opting for lactose-free dairy products, and incorporating fermented dairy products like yogurt and buttermilk into the diet.

4. What are the 4 stages of lactose intolerance?

The four stages of lactose intolerance are: 1) lactose intolerance without symptoms, 2) lactose intolerance with mild symptoms, 3) lactose intolerance with moderate symptoms, and 4) lactose intolerance with severe symptoms.

5. Which milk is lactose free in India?

In India, lactose-free milk options include brands like Fast&Up. They offer oat and almond milk.

6. How do you flush dairy out of your system?

To flush dairy out of your system, drink plenty of water to stay hydrated, consume fiber-rich foods like fruits and vegetables, and consider incorporating natural diuretics like herbal teas or cranberry juice.