Bloating. Belching. Abdominal cramps. Vomiting. Diarrhea. Constipation. If you struggle with any of these symptoms after eating or drinking dairy products, it’s easy to conclude you’re allergic to milk. That’s what many people with lactose intolerance assume when they decide to sacrifice dairy products.
However, their self-diagnosis may be completely off. Allergies are an immune system dysfunction, while lactose intolerance is an enzyme deficiency. It’s your body’s underproduction of lactase (which breaks down the lactose in milk) that may be causing your symptoms.
It’s quite common to become lactose-intolerant later in life. According to the National Institute of Health, about 65 percent of the global population has a reduced ability to digest lactose after infancy.
About 30% of American adults are lactose intolerant. If you’re part of this statistic, your body has trouble breaking down the disaccharide lactose that’s found in dairy products, in some non-dairy foods, and in certain vitamins and medications.
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People with milk allergy often have a reaction within minutes of eating dairy. Skin rashes, hives, itchiness, and stomach pain can morph into more serious symptoms like labored breathing, diminished blood circulation, and even anaphylaxis, sometimes after just a single dab of dairy. Most of them develop milk allergy as children, then outgrow it. Adults, whose immune systems have already been stabilized, don’t usually develop food allergies.
Lactose intolerance, on the other hand, often takes longer to manifest— sometimes hours. That’s because lactose needs time to flow through your gastrointestinal tract and reach your colon. Once it gets there, you may experience gas, bloating, stomach upset, or diarrhea – uncomfortable, but not life-threatening.
Also, the severity of symptoms typically depends on the quantity of lactose you consume. Because your gut’s physiology declines with age, it's more likely that your recently discovered reaction to dairy is lactose intolerance.
Lactose intolerance is caused by an imbalance of lactose and lactase.
What is lactose made of? Two simple sugars: glucose and galactose. It’s a disaccharide (a class of sugars whose molecules contain two monosaccharide residues) found in dairy products. Normally, your body digests disaccharides by breaking them into the two individual sugar molecules that your small intestine is able to absorb.
What is lactase? An enzyme that unpairs these two simple sugars, so they can be absorbed into your bloodstream, where they’re used (and stored) as energy.
When your small intestine lacks lactase, you are lactose intolerant. Most people have primary lactose intolerance – the waning of lactase production with age. If it’s gut wall inflammation that’s reducing your lactase, you’ll be diagnosed with secondary intolerance.
Undigested lactose ferments in your gut, where bacteria breaks it down into short-chain fatty acids and gas. People with severe lactose intolerance can develop symptoms after eating just 12 grams of lactose from breast, goat, and cow’s milk, or milk byproducts, solids and milk powder. Lactose from less obvious sources like processed foods and medications can also cause these symptoms.
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