Lactose Intolerance

Lactose intolerance (LI) is a common disorder that affects a quarter of the US population and may affect as many as 75% of the world population. The prevalence varies by race and ethnicity. It is more common among African-Americans, Hispanics and oriental population. In India, for example, it is seen in 25% of north Indian and 70% of south Indian population.

Most common for is the adult-type or primary deficiency where there is usually deficiency of Lactase enzyme activity and not complete absence. Congenital lactase deficiency is rare.

Milk intolerance suggests onset of symptoms after drinking milk and not necessarily lactose intolerance.

Symptoms of Lactose Intolerance include bloating, stomach pains, diarrhea and gassiness. Symptoms may occur in some patients even when their lactase enzyme activity is within normal limits. This may occur in 5% of adults. Thus, some people erroneously think that their symptoms are due to lactase deficiency when that is not true.

Lactose restricted diet may improve symptoms not only in lactase deficient patients but also in irritable bowel syndrome in adults and recurrent abdominal pain in kids.

Diagnosis of LI may be made by lactose tolerance test (blood), or breath hydrogen breath test. Assessment of lactase activity in the biopsy of the small intestine is the most direct and definitive test, but is cumbersome and used for research only.

LI is usually not absolute. Most patients can tolerate 240 ml of milk per day without problems.

Yogurt containing lactose is well tolerated by the patients. This occurs because the yogurt contains live cultures of bacteria and the lactase produced by these bacteria digests the yogurt lactose.

Please be aware that lactose is frequently a part of many prescription and over-the-counter drugs, and may impact susceptible individuals.

People on lactose restricted diet should take supplemental calcium.

Over the counter treatment of LI is a multibillion dollar industry. Lactase enzyme is available as capsules, tablets and solutions for lactase deficient patients. The amount of lactase needed to digest a specific amount of lactose depends on the product used. Thus, all products are not created equal.

This Lactose Intolerance is meant to be an informational exercise and NOT a medical consultation
Your doctor is the only one who can best assess your situation and offer you medical advice

Above is based on Dr. Minocha’s article that appeared in September 1998 issue of Postgraduate Medicine.

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