Lactose Intolerance – Diagnosis and Treatment

Lactose intolerance affects how your body digests lactose, the sugar in milk and dairy products. People with this condition usually can’t break down lactose well because they don’t make enough of the enzyme lactase.

Symptom	How It Appears
Gas	Passing wind, feeling gassy
Bloating	Stomach feels full or tight
Diarrhea	Frequent, loose stools
Abdominal pain	Stomach aches or cramps
Nausea/Vomiting	Feeling sick or sometimes vomiting

Lactose intolerance usually brings on symptoms like diarrhea, bloating, gas, abdominal pain, and sometimes nausea or cramps. Some people even get vomiting. These signs can show up soon after you eat or drink something with lactose.

This happens to a lot of people, regardless of age or background.

Diagnose

You can spot lactose intolerance by looking at your symptoms and, if needed, taking certain tests. Healthcare providers often start by asking about your stomach problems and how you feel after eating dairy.

If you feel better after cutting out dairy, that’s a big clue.

Here are some common tests:

• Hydrogen Breath Test: You drink a lactose-filled liquid, then breathe into a machine. If your breath shows a lot of hydrogen, your body probably isn’t breaking down lactose well.
• Lactose Tolerance Test: After drinking lactose, they check your blood sugar. If it doesn’t rise much, you’re probably not digesting lactose.

These tests can confirm if your body struggles with lactose, hinting at low lactase levels.

Treatment

Most people manage lactose intolerance by changing what they eat and using certain products.

Here are some helpful ideas:

• Limit dairy foods so you eat less lactose.
• Eat small amounts of dairy with meals to see if you tolerate them better.
• Pick lactose-reduced milk and ice cream instead of regular versions.
• Try lactase enzyme supplements (like tablets or drops) before you eat foods with lactose.
• Add liquid or powder lactase to milk to help break down lactose.

If you need more calcium, calcium supplements can help you get enough without dairy.

Taking Care of Yourself

Getting Enough Nutrients

You can get important nutrients like calcium and vitamin D even if you eat less dairy. Many foods help you meet these needs without using regular milk or cheese.

Try these for more calcium:

Food Type	Examples
Vegetables	Broccoli, kale, collard greens
Calcium-Fortified Foods	Orange juice, cereals
Fish (With Edible Bones)	Salmon, sardines
Plant-Based Drinks	Soy milk, rice milk
Fruits and Nuts	Oranges, almonds, Brazil nuts
Legumes	Dried beans

Vitamin D is also key for bone health, but a lot of adults don’t get enough. Besides fortified milk, you can get vitamin D from:

• Sunlight (your body makes vitamin D when your skin gets sun)
• Eggs
• Yogurt
• Liver

If you avoid most dairy, ask your healthcare provider about supplements. Some people need a calcium or vitamin D supplement if their diet isn’t enough.

Cutting Down on Regular Dairy

You don’t always have to give up all dairy if you have lactose malabsorption. Most people can handle small amounts of milk or other dairy.

Low-fat or lactose-reduced options might be easier to digest.

Here are a few ways to handle dairy:

• Eat Small Portions: Try drinking a little milk at a time (like 4 ounces). That might cause fewer problems.
• Have Dairy with Food: Eat milk, yogurt, or cheese with meals to slow digestion and help your stomach.
• Try Different Dairy Products: Some have less lactose. Hard cheeses or cheddar usually have less lactose than soft cheeses or regular milk.
• Look for Lactose-Free or Lactose-Reduced Products: Supermarkets carry lots of these, and they’re made to be easier on your stomach.
• Use Enzyme Supplements: Lactase enzyme tablets or drops can help some people digest dairy. You can take them before eating or add them to milk.

Everyone’s tolerance is different, so you’ll need to experiment a bit to see what works for you. Make small changes and notice how your body reacts to balance comfort and nutrition.

Other Ways to Manage Lactose Intolerance

Probiotics—live microbes—support healthy digestion. You’ll find them in some yogurts with live cultures and in pill supplements.

Some people use probiotics to help with diarrhea or irritable bowel syndrome. They might also help your body break down lactose.

Most people can safely take probiotics, and they’re worth a try if regular treatments aren’t doing enough.

Example Sources	Notes
Yogurt with live cultures	Supports digestion
Capsule supplements	Easy to take daily

Getting Ready for Your Doctor Visit

Getting ready for your doctor’s visit about lactose intolerance helps things go smoother. Start by asking if you need to avoid certain foods or drinks before your appointment.

Make a list that covers:

• Your Symptoms: Write down every symptom, even if it doesn’t seem related. Note when and how often they happen.
• Medicines and Supplements: List all prescription and over-the-counter drugs, vitamins, and supplements, with amounts and frequency.
• Questions for Your Doctor: Some ideas:
  • What else could cause my symptoms?
  • Will I need tests?
  • What are my treatment options?
  • Do I need to avoid dairy completely?
  • How do I get enough calcium without milk?
  • Should I see a dietitian?
  • How do my other health issues affect lactose intolerance?

Tip: Bring a notebook or use your phone to jot down advice and answers during your visit.

Before Your Visit Checklist	Details
Call the clinic and ask about prep	Food or drink restrictions?
List your symptoms	What, when, how often
List all medicines and supplements	Type, amount, how often
Prepare questions	See suggestions above

Things You Can Try While Waiting

Keep a food diary. Write down everything you eat with dairy—milk, yogurt, cheese, or ice cream. Record when you eat it and if you notice any stomach problems after.

Bring this log to your appointment. If you think dairy makes your symptoms worse, try cutting out dairy for a few days. Track how you feel without it.

Be ready to share these notes with your doctor, since this info can help figure out what’s causing your symptoms.

Simple steps:

• Watch how your body reacts to lactose-containing foods.
• Note if things improve or stay the same when you avoid dairy.
• Stay hydrated and don’t skip meals while making changes.

Tracking your experience helps your doctor make a more accurate diagnosis and guide you to the best plan.