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What is lactose intolerance?

An enzyme in the small intestine "lactase" break down lactose (milk sugar) into smaller sugars units "glucose" and "galactose”. Deficiency of lactase or reduced activity of enzyme causes lactose intolerance. Lactose is supposed to enhance calcium absorption. About 50%  of the adults from Asian and African population suffer from lactase deficiency.


  • Primary lactose intolerance: Environmentally induced when weaning a child in non-dairy consuming societies. This is found in many Asian and African cultures, where industrialized and commercial dairy products are uncommon.
  • Secondary lactose intolerance: Resulting from the certain Gastrointestinal disorder such as Irritable Bowel Syndrome (IBS), or as a consequence of infection of the small intestine, HIV or malnutrition. In children, it is typically secondary to viral or bacterial infections.
  • Congenital lactase deficiency: A genetic disorder which prevents the enzymatic production of lactase. Present at birth, and diagnosed in early infancy.


  • Diarrhoea
  • Abdominal pain
  • Flatulence
  • Bloating
  • Lactose tolerance test
  • Hydrogen Breath test
  • Stool acidity test





Management of lactose intolerance requires dietary changes.

  • Total elimination of lactose. Milk substitute like soy milk, groundnut milk, coconut milk to be used.
  • Those who do not have absolute lactase deficiency can tolerate about 6 to 12 g of lactose/ day without major symptoms, especially when taken with meals or in the form of cheeses.
  • A fermented and cooked form of milk preferred as lactose gets converted to lactic acid. Curd or yoghurt may be well tolerated due to the presence of beta-galactosidase an enzyme which ferments lactose to lactic acid.
  • A person who avoids dairy products may need calcium or Vit D supplementation.
  • Lactaid enzyme (Lactase enzyme supplement ) may be used which can be added to milk.
  • All packed food label should be checked for lactose before purchase.

  Food that may contain hidden lactose include :

  • Biscuits and cakes (if milk or milk solids are added)
  • Processed breakfast cereals
  • Cheese sauce, Cream Soups and Custard
  • Milk chocolate
  • Pancakes and pikelets
  • Scrambled eggs
  • Muesli bars
  • Some bread and margarine (containing milk).

Trying to avoid lactose, ingredients to look for in lists on food labels.

  • Milk Solids
  • Non-fat Milk Solids
  • Whey
  • Milk Sugar



This is Copyright Content by Gadge's Diabetes Care Edited and written by Madiha Khan


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