What is lactose intolerance and how do you recognize it

Many people have a lactose intolerance, maybe you too?

Do you think you have lactose intolerance because you often suffer from a bloated stomach, flatulence, intestinal cramps, and diarrhea? Lactose intolerance is more common than you think. For example, in the Netherlands, where I come from, more than 2.5 million people suffer from lactose intolerance. That is about 1 in 7 people!

Unfortunately, it is not often talked about openly. Many people are ashamed if they often have to blow (dirty) winds or have diarrhea, so they prefer not to say anything. Or they cover their swollen stomach with loose-fitting clothing, which is caused by the consumption of milk within a few hours.

Read below what exactly lactose intolerance is, in simple language without many medical terms. Reassure yourself that you are not alone with these uncomfortable complaints and read what you can do best to have a ‘happy’ stomach again.


Note: Hi, my name is Muriel and I enjoyed writing this article. Because I am Dutch, my English may not be optimal, but I do my best. Sorry for that. But I hope this blog article still inspires and informs you.


Lactose intolerance: what is that simply explained?

If you suffer from lactose intolerance, there is clearly something wrong: your body has declared war on milk and milk products. Your small intestine is no longer able to digest milk properly and the undigested milk then ends up in your colon. There, an entire army is ready to digest milk. This army consists of bacteria from the intestinal flora. With all their might they try to digest the milk by fermenting it. And you will often feel that! Abdominal distension, flatulence, diarrhea, and nausea are some of the reactions that arise. And then you are left with an unhappy stomach.


Lactase is needed to digest lactose

To know exactly what is happening in your body, it is useful to know what lactose and lactase are. Much has been written about it on the internet, but I sometimes find that described too medically. That is why I came up with a description for myself in simple language and I would like to share that with you.

It is helpful to know that lactose is a type of sugar naturally found in milk. A handy mnemonic is that it is often also called milk sugar: lactose is, therefore, a sort of sugar that is in milk. To digest the milk sugar in your body, your body needs an aid: the enzyme lactase. Lactase is normally produced in your small intestine wall. And lactase does something very beautiful: it ensures that the milk sugar (lactose) is split into two parts. One part is glucose and the other part is galactose.

You can quickly forget these terms, but the point is that through the split, the milk is now absorbed and digested by your body. Unfortunately, this does not happen if you suffer from lactose intolerance …


What happens if the lactase is missing?

If you suffer from lactose intolerance, your small intestine no longer knows how to produce enough lactase. The milk moves undigested, or actually unsplit, from your small intestine to your large intestine. The army of bacteria from your intestinal flora is ready in your colon. They make one more attempt to attack the milk sugar by using the fermentation trick. And this is the moment when you often feel complaints arise. Or maybe earlier. The fermentation of the milk sugar usually results in a bloated stomach, flatulence, intestinal cramps, diarrhea and / or nausea. Gone is your appetite and gone is your pleasure in the dinner you were looking forward to.


this is what happens in your gut if you have lactose intolerance


You also sometimes hear about cow’s milk allergy, what is that?

To take a side step from lactose intolerance, I also give you information about cow’s milk allergy. Cow’s milk allergy appears to be something completely different. It may be confusing because both lactose intolerance and cow’s milk allergy are both caused by eating and drinking dairy products. And the complaints are often the same!

But in reality, something completely different is happening in your body. The small intestine is the culprit in lactose intolerance. It produces too little lactase to digest the milk. With cow’s milk allergy, your immune system is the culprit that does not know how to deal with the proteins in the milk. In both cases, another “war” is taking place in your body, as it were. With lactose intolerance, you get complaints because of the fight that the bacteria in your colon enter into with the milk. With cow’s milk allergy, you will suffer from complaints due to the fight that the immune system engages with the milk proteins.

Cow’s milk allergy causes an allergic reaction and you often hear that cow’s milk allergy also causes other complaints, such as rash, eczema, and shortness of breath.


From what age can you get lactose intolerance?

Anyone can get it, whether you are a baby or an adult. But it really differs per person whether, and if so, at what age you get lactose intolerance. The funny thing is that it even plays a role where you were born in the world. You can read that below. But first, you can say that 3 forms of lactose intolerance can develop at different ages: primary lactose intolerance, secondary lactose intolerance, and congenital lactose intolerance.


Primary lactose intolerance

As a baby, enough lactase is produced by your small intestine to digest a large amount of (mother) milk. (Mother) milk is often the only thing you get as a baby, so the production of lactase by the baby’s body works at full speed. As you get older, you start to eat other foods and therefore your body needs less lactase. As a result, less and less lactase is produced, while you still need it quite often. In fact, almost no lactase is produced in people in Southern Europe and the Far East around the third year of life. There, lactose intolerance is highest.


Secondary lactose intolerance

Simply said, this form of lactose intolerance occurs when your small intestine wall is damaged. This can happen after an illness or surgery. This causes the production of lactase to decrease sharply for a period. Or in the worst case, it could even be forever.


Congenital lactose intolerance

As a parent, you sometimes don’t know what to do if your baby often suffers from stomach cramps or diarrhea. The doctor has to find out whether it is due to the consumption of milk. If it is suspected that it is milk, then it is important to find out whether it is, for example, lactose intolerance or cow’s milk allergy. You can take measures based on this.


Complaints with lactose intolerance

The most common complaints with lactose intolerance are: abdominal distension, flatulence, intestinal cramps, diarrhea, nausea and vomiting. This is different for everyone. I notice that I hardly suffer from nausea and vomiting, but rather from a bloated stomach, flatulence, and sometimes diarrhea. And I’m not even talking about the feeling that I have, such as shame, sometimes not wanting to be in the company of others and dissatisfaction with my bloated stomach (it seems like I’m too fat, like I’m having a balloon belly!)


happy balloon messy belly


Within how many hours do you get complaints?

Babies and small children can develop intestinal cramps and diarrhea within 20 minutes of consuming milk. In adults, this can also go so quickly, although you often hear that complaints arise within 2-4 hours after you have eaten or drank milk products. For example, I can set the clock that I often get problems after 2 hours.


Also read: 5 frequently heard complaints with a lactose intolerance!


How do you know if you’re lactose intolerant?

One of the best ways to test it is to not eat milk or milk solids for a month. That worked best for me and I actually knew within a week: I had a calm stomach and no more problems with a bloated stomach, flatulence, and diarrhea. In the beginning, it is very difficult to really avoid all milk products or milk ingredients, because it is in an incredible number of products. There are also different names for milk and milk components. That makes it extra complicated. But by consistently reading the label of a product you can avoid a lot of hassle. From that time on, I have developed the habit of looking directly at what the ingredients are for a product. And when in doubt, I just don’t eat it.


How can you find out more?

So you can do your own test whether you are lactose intolerant by not consuming milk products for a month. If your complaints decrease sharply, there is a good chance that you have lactose intolerance. But you may not be 100% sure. Feel free to ask your doctor how to find out if you have lactose intolerance. There are also other ways to find out:


Elimination challenge test

For example, you cannot eat or drink milk products for a month under the guidance of a dietitian. This is officially called the elimination challenge test. First, you do not eat or drink milk and milk products for a month and after a month a little lactose is added to your diet again. If your symptoms first reduce drastically and increase again after adding lactose, then you know that there is a good chance that you have lactose intolerance.


Hydrogen breath test

There is also another way, namely the hydrogen breath test. If you have a high concentration of hydrogen in your breath, you may be lactose intolerant. Normally, lactose is broken down by lactase in the colon. But if this doesn’t happen, because you have lactose intolerance, then fermentation of the lactose is taking place in your colon. This is not good and the fermentation creates a higher concentration of hydrogen and this can be found in your breathing, among other things.


Lactose Tolerance Test (LTT)

You can also opt for a Lactose Tolerance Test (LTT). Another name is the blood sugar test. If your body can digest the lactose perfectly, then the lactase does its job and splits the lactose into two components. One of these components is glucose and glucose is well absorbed by your blood. But if there is no or insufficient lactase in your body, the lactose will enter your colon undigested! In your blood there are no traces of an increased amount of sugar in your blood. This may indicate lactose intolerance.



I hope the above information has helped you. How did you find out that you have lactose intolerance? And do you have any tips? Great if you want to share it below!


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What is lactose intolerance and how do you recognize this