What Is Lactose Intolerance?

Lactose is a sugar found in milk. Lactose intolerance is the inability to fully digest lactose, resulting in gastrointestinal issues about 30 minutes to 2 hours after consuming dairy products.

Symptoms of lactose intolerance include: 

• Abdominal bloating 
• Stomach rumbling (borborygmus) 
• Abdominal pain or cramps 
• Diarrhea 
• Gas, or flatulence 
• Nausea, sometimes with vomiting 

Importantly, lactose intolerance is not the same thing as a milk allergy, which occurs when your immune system overreacts to the proteins in milk. If you have a milk allergy, you will likely immediately experience typical allergy symptoms after consuming milk, including hives, wheezing, and vomiting.

How Lactose Intolerance Develops

When you consume food or drink containing lactose, an enzyme in the small intestine called lactase helps you digest the milk sugar via hydrolysis, or the chemical splitting of molecules with water. In effect, lactase catalyzes the hydrolysis of lactose, producing two simpler sugars: glucose and galactose, which are then absorbed into the bloodstream.

Many people have a lactase deficiency, or hypolactasia, in which their small intestine produces low levels of lactase. This deficiency may lead to lactose malabsorption, wherein the undigested lactose makes its way into the large intestine and colon. Bacteria in the colon break down the lactose, resulting in increased gas and fluid in colon.

You are lactose intolerant if your lactase deficiency or lactose malabsorption causes digestive symptoms (though this doesn’t always happen).

The amount of lactose required to cause symptoms varies between people, and most people are able to consume small amounts of lactose without issues, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

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