The most important thing:
- What should we know about the digestive disorder lactose intolerance?
- How can we recognise the symptoms and how is it diagnosed?
- Living with lactose intolerance – diet, products that help break down lactose, and food alternatives
Dairy products make up a large part of the European diet from early childhood. They are an important source of protein and also provide the body with the necessary amount of calcium for healthy bones, as well as other vitamins such as D, B12, B2 (riboflavin) and minerals such as phosphorus, potassium and magnesium.
Nowadays, however, people are often diagnosed with lactose intolerance and have to radically change their lifestyle and diet. It often comes as an answer to the question of why various symptoms such as gas, bloating, stomach pain, and sometimes even more serious ones such as vomiting and diarrhoea occur. Lactose intolerance is not just a modern diagnosis – it is a very real problem that affects millions of people around the world.
If you are one of these millions, it is essential to understand this intolerance and know how to manage it. In this article, we will cover everything you need to know about the topic – from symptoms and diagnosis to effective methods of control and treatment.
What is lactose intolerance?
Lactose and the lactase enzyme
Milk and dairy products contain a natural sugar called lactose. When we consume them, our body uses an enzyme called lactase to break them down and absorb them, extracting the aforementioned beneficial substances and vitamins. Lactase is produced in the small intestine and breaks down lactose into two smaller sugars – glucose and galactose. When, for one reason or another, the enzyme is reduced, the process does not occur, and the lactose remains undigested and passes into the large intestine, where it causes a number of unpleasant symptoms.
Types of lactose intolerance
There are three main types of lactose intolerance
- Primary – the most common and therefore affecting the most people. It occurs because lactase production naturally decreases with age.
- Secondary – occurs as a result of disease or trauma to the intestines (e.g. gastroenteritis, coeliac disease).
- Congenital (congenital alactalasia) – this type of intolerance is very rare and manifests itself at birth, when the baby cannot break down lactose even in breast milk.
Why do so many people suffer from lactose intolerance?
The percentage of people suffering from some form of lactose intolerance worldwide is extremely high – around 70%. In some ethnic groups (e.g. Asians, Africans, Latin Americans) the percentage is even higher. Genetics plays a decisive role – in certain regions, people have inherited genes that maintain lactase activity and with age, while in others this function weakens.
In Bulgaria, lactose intolerance is not uncommon, but the percentage is not as high – about 25-30% of Bulgarians suffer from it. Some local dairy products, such as yoghurt, for example, are better tolerated by the body because fermentation breaks down some of the lactose.
What are the symptoms and how can we recognise it?
Digestive problems
As already mentioned, the most common symptoms are digestive problems, most often occurring 30 minutes to 2 hours after consuming milk and other dairy products. These include:
- Bloating
- gas
- Abdominal pain and cramps
- Nausea
- diarrhoea
These reactions are due to the fermentation of undigested lactose by bacteria in the large intestine, which produces gas and organic acids. Symptoms vary depending on the amount of lactose consumed and the level of lactase activity. For example, a glass of milk may not cause problems for someone with a mild form, but may be disastrous for another. Symptoms usually last a few hours, but can persist for up to 24 hours in the case of a stronger reaction.
Related symptoms outside the stomach
In addition to digestive problems, some people also report other symptoms, including:
- general fatigue and weakness
- irritability
- skin rashes
- headaches
It is important to note that these symptoms are not directly caused by lactose, but may be the result of chronic discomfort and an imbalance in the gut microbiota.
Diagnosis
Elimination diet
The first step is personal observation, i.e. if you notice that stomach discomfort occurs after consuming dairy products. Then it is a good idea to consider an elimination diet – avoid milk and dairy products containing lactose for at least 2-3 weeks. Then slowly start reintroducing them into your diet, while monitoring your body’s reactions.
Medical tests
If the symptoms recur frequently and you have a strong suspicion that you have an intolerance, consult a doctor. They may recommend:
- Hydrogen breath test – measures the amount of hydrogen in exhaled air after consuming lactose. An elevated level indicates fermentation of undigested lactose.
- Blood test for lactose tolerance – after drinking a beverage containing lactose, the blood glucose level is monitored. Since lactose is a sugar, if there is no increase, i.e. it has not reached the blood, it means that your body is not breaking it down properly.
The difference with milk allergy
It is important to note that lactose intolerance is not a milk allergy. The latter is an immune reaction to milk protein and can be life-threatening. Symptoms include rashes, swelling, shortness of breath, and anaphylaxis. If in doubt, be sure to consult an allergist.
Treatment and ways to deal with the problem
Diet
The most effective approach is to limit or completely avoid products containing lactose. This may sound extreme or complicated, but it does not mean the end of delicious food, just more careful planning. Products that usually contain lactose include milk, cheese, yoghurt, cream, butter and even some ready-made foods that you may not suspect, such as biscuits, ready-made dressings, etc.
Over time, you will begin to recognise the foods that cause a strong reaction. These are not the same for everyone – some people tolerate hard cheeses with low lactose content, such as Parmesan and Cheddar, while others do not. The amount can also be a determining factor; for example, you may have no problem drinking your morning coffee with a little milk or cream, but a glass of fresh milk would be unthinkable.
Taking a lactase product
Sometimes it is not easy to avoid lactose 100%, especially if you love dairy products, are going on a trip or have an occasion where it would be more difficult to plan your meals. In such cases, lactase enzyme products such as Estocal come to the rescue. They are taken before consuming foods containing lactose and help break it down in the intestines.
The Estocal formula contains a high amount of the enzyme – 7,000 FCC units in the recommended dose of two tablets, making it suitable for use even with significant amounts of lactose in the diet. It is taken immediately before consuming dairy products and, in addition to helping break down lactose, it significantly reduces the risk of bloating, gas and abdominal discomfort. The product is a practical solution for people who do not want to completely deprive themselves of dairy foods and is especially useful when eating out, travelling or at social events.
Probiotics and healthy intestinal flora
The condition of the intestinal microflora plays a key role not only in lactose tolerance, but also in overall digestion and immunity. Probiotics, beneficial bacteria that aid digestion and overall intestinal health, are primarily responsible for this. Some studies show that taking certain strains of probiotics can improve lactose tolerance in people with mild to moderate intolerance.
The best probiotic sources in food include fermented foods such as kimchi, sauerkraut, pickles, and some yoghurts (there are also lactose-free options). There are also many probiotic products on the market that can be combined with a lactose-free diet.
Maintaining healthy gut flora through a proper diet and probiotics can alleviate symptoms and improve quality of life. B-protekt is a high-quality probiotic and synbiotic.
Lactose-free living – mission possible
Dairy substitutes
Nowadays, we are blessed with an abundance of alternatives to traditional dairy products, making lactose-free living easier than ever. Some popular substitutes include:
- Milk – soy, almond, rice, oat, coconut
- Yoghurts – coconut, soy or almond-based
- Cheese – vegan cheeses made from cashews, almonds or potatoes
- Cream and butter – plant-based creams and butters made from coconut or sunflower
Many of these products are fortified with calcium, vitamin D and B12, making them excellent nutritional substitutes.
Conclusion
Lactose intolerance is a common condition that can significantly affect quality of life if not recognised and managed properly. The symptoms are unpleasant but controllable, especially with the right diet, enzyme supplements and alternative foods. With the help of modern options, a lactose-free life can be not only healthy, but also delicious and varied. Don’t give up the pleasure of food – just make informed choices.
