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Alternative Names Return to topLactase deficiency; Milk intolerance; Disaccharidase deficiency; Dairy product intolerance
Definition Return to top
Lactose intolerance is the inability to digest lactose (a type of sugar found in milk and other dairy products).
Causes Return to top
Lactose intolerance happens when the small intestine does not make enough of the enzyme lactase. Babies' bodies make this enzyme so they can digest milk, including breast milk. Before humans became dairy farmers, most people did not continue to drink milk, so their bodies did not make lactase after early childhood.
Lactose intolerance is more common in Asian, African, African-American, Native American, and Mediterranean populations than it is among northern and western Europeans.
Lactose intolerance can begin at different times in life. In Caucasians, it usually starts to affect children older than age 5. In African-Americans, lactose intolerance often occurs as early as age 2.
Lactose intolerance is very common in adults and is not dangerous. Approximately 30 million American adults have some amount of lactose intolerance by age 20.
Lactose intolerance is sometimes seen in premature babies. Children who were born at full term generally do not show signs of lactose intolerance until they are at least 3 years old.
Not having enough lactase (lactase deficiency) may also occur as a result of intestinal diseases such as celiac sprue and gastroenteritis, or after bowel surgery. Temporary lactase deficiency can result from viral and bacterial infections, especially in children, when the cells lining the intestine are injured.
Symptoms Return to top
Symptoms often occur after you eat or drink milk products, and are often relieved by not eating or drinking milk products. Large doses of milk products may cause worse symptoms.
Exams and Tests Return to top
Treatment Return to top
Removing milk products from the diet usually improves the symptoms. However, not having milk in the diet can lead to a shortage of calcium, vitamin D, riboflavin, and protein. Add other sources of calcium to the diet if you remove milk products.
Most people with low lactase levels can tolerate 2 - 4 ounces of milk at one time (up to one-half cup). Larger (8 oz.) servings may cause problems for people with some amount of milk intolerance.
These milk products may be easier to digest:
You can add lactase enzymes to regular milk or take them in capsule or chewable tablet form.
You may need to find new ways to get calcium into your diet (you need 1,200 - 1,500 mg of calcium each day):
Read food labels. Lactose is also found in some non-milk products -- including some beers.
Outlook (Prognosis) Return to top
Symptoms usually go away when milk products are removed from the diet.
Possible Complications Return to top
Weight loss and malnutrition are possible complications.
When to Contact a Medical Professional Return to top
Call your health care provider if:
Prevention Return to top
There is no known way to prevent lactose intolerance.
If you have the condition, avoiding or restricting the amount of milk products in your diet can reduce or prevent symptoms.
References Return to top
Information from your family doctor. Lactose intolerance: what you should know. Am Fam Physician. 2006;74:1927-1928.
Hogenauer C, Hammer HF. Maldigestion and Malabsorption. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2006: chap98.Update Date: 8/22/2008 Updated by: Christian Stone, MD, Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.