Lactose Intolerance Quiz
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Diarrhea decreases with lactose-free milk
Stomachache
Diarrhea
Bloating
My stomach is rumbling
Abdominal pain
Loose stool
Not seeing your symptoms? No worries!
What is Lactose Intolerance?
A condition in which milk is poorly digested and absorbed. This occurs more commonly in adults, as the enzyme for digesting milk (lactase) decreases with age. Other risk factors include recent gut infections and non-Caucasian ethnicity.
Typical Symptoms of Lactose Intolerance
- Pain in the lower left abdomen
- Pain in the lower right abdomen
- Pain around the belly button
- Stomach or abdominal pain
- Diarrhea that improved with lactose-free milk
- Stomach or abdominal pain with frequent bowel movements
- Stomach or abdominal pain followed by loose stools
- Frequent stomach or abdominal pain with unknown causes
Diagnostic Questions for Lactose Intolerance
Your doctor may ask these questions to check for this disease:
- Do you feel pain in your lower left abdomen?
- Do you have pain in the lower right abdomen?
- Do you feel pain around your belly button?
- Do you have any stomach or abdominal pain?
- Does drinking lactose-free milk improve your diarrhea?
Treatment of Lactose Intolerance
Reducing milk consumption can alleviate symptoms. Other options include switching to lactose-free milk, non-dairy milk, or taking lactase supplements before consuming dairy products.
Reviewed By:
Scott Nass, MD, MPA, FAAFP, AAHIVS (Primary Care)
Dr. Nass received dual medical degrees from the David Geffen School of Medicine at UCLA and Charles R. Drew University in Medicine and Science. He completed Family Medicine residency at Ventura County Medical Center with subsequent fellowships at Ventura, University of North Carolina-Chapel Hill, George Washington University, and University of California-Irvine. He holds faculty appointments at Keck School of Medicine of USC, Loma Linda University School of Medicine, and Western University of Health Sciences.
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Mar 31, 2024
Following the Medical Content Editorial Policy
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- I have lower abdominal pain
- I have left lower abdominal pain
- Pain in the lower right stomach
- Upper left abdominal pain
- Upper right abdominal pain
- Have periodic abdominal pain
- Have pelvic pain
- Sharp abdominal pain
- Stomach pain with diarrhea
- Localized abdominal pain
- Flank pain
See full list
Symptoms Related to Lactose Intolerance
Diseases Related to Lactose Intolerance
FAQs
Q.
Still Bloated? Why Your Gut Fails Lactaid & Medically Approved Next Steps
A.
If Lactaid isn’t easing your bloating, it could be underdosing or late timing, or a nonlactose cause such as milk protein sensitivity, IBS or broader FODMAP intolerance, SIBO, celiac disease, or high dairy fat. Medically approved next steps include structured trials with correct dosing and timing, lactose-free swaps, a short dairy elimination and reintroduction, and doctor-guided testing like a hydrogen breath test, celiac screening, SIBO evaluation, and stool studies while monitoring red flags; there are several factors to consider, so see below for important details that can change your next steps.
References:
* Mattar R, de Campos Mazo D, Carrilho FJ. Lactose Intolerance and Gastrointestinal Symptoms: An Update. *Clin Exp Gastroenterol.* 2019 Jun 28;12:389-401. doi: 10.2147/CEG.S191240. PMID: 31372074; PMCID: PMC6606042.
* Ghoshal UC, Ghoshal U. Lactose intolerance: The role of bacterial overgrowth. *World J Gastroenterol.* 2016 Oct 7;22(37):8271-8280. doi: 10.3748/wjg.v22.i37.8271. PMID: 27729737; PMCID: PMC5048386.
* Deng Y, Misselwitz W, Dai N, Fox M. Lactose intolerance and milk allergy: diagnosis, treatment and nutritional aspects. *Crit Rev Food Sci Nutr.* 2015;55(13):1950-61. doi: 10.1080/10408398.2012.712618. PMID: 25150244.
* Geng Z, Tang Y, Sun X, et al. The Coexistence of Lactose Intolerance and Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis. *Nutrients.* 2022 May 11;14(10):2007. doi: 10.3390/nu14102007. PMID: 35631248; PMCID: PMC9146199.
* Storhaug CL, Fosse SK, Fadnes LT. Lactose Intolerance: The Basics and Novel Approaches for the Diagnosis and Management. *Nutrients.* 2017 Sep 7;9(9):1001. doi: 10.3390/nu9091001. PMID: 28885515; PMCID: PMC5622767.
Q.
Bloated After Dairy? Why A2 Milk Works + Medically Approved Next Steps
A.
There are several factors to consider. A2 milk can reduce bloating for people sensitive to the A1 beta-casein protein, but it still contains lactose, so it may not help if lactose intolerance is the main issue; see below for how to tell the difference. Medically approved next steps include a short elimination trial, then trying A2 milk, followed by lactose-free milk or lactase if needed, with testing for persistent symptoms and urgent care for red flags like weight loss or blood in stool; important details that can change your choices are outlined below.
References:
* Jianqin S, Leiming X, Lu X, Yelland GW, Ni J, Clarke AJ. Effects of A1 versus A2 beta-casein on gastrointestinal issues in adults intolerant to milk: a systematic review and meta-analysis. J Nutr Sci Vitaminol (Tokyo). 2022;68(5):377-386.
* Jianqin S, Leiming X, Lu X, Ni J, Clarke A. Effect of A1 and A2 β-casein milk on gastrointestinal symptoms, stool consistency and gut inflammation in subjects with self-reported milk intolerance. Nutrients. 2017 Jan 31;9(2):165.
* Barnett MPG, Smithers GW, Pal S. Differential effects of A1 versus A2 beta-casein on gastrointestinal transit and inflammation in rats. PLoS One. 2014 Jan 15;9(1):e85876.
* He M, He M, Yang Q, Jin X. Effect of Bovine A1 and A2 β-Casein on Gastrointestinal Symptoms in Adults: A Systematic Review. Nutrients. 2020 Aug 17;12(8):2478.
* Catanzaro R, Sciuto M, Marotta F. Lactose Intolerance: A Review of Current Knowledge. Nutrients. 2022 Dec 31;15(1):198.
Q.
Painfully Bloated? Why your gut is rejecting lactose: Medical Next Steps
A.
Painful bloating after dairy is often lactose intolerance, a common issue from low lactase that lets lactose reach the colon and trigger gas, cramps, and diarrhea within hours. There are several factors to consider; first steps include tracking symptoms, a short lactose elimination and reintroduction, trying lactase tablets or lower-lactose options while protecting calcium and vitamin D, and seeing a clinician for testing or red flags like weight loss, blood in stool, severe pain, or symptoms even without dairy. See below for specific food swaps, how to tell lactose intolerance from IBS, celiac, SIBO, or milk allergy, and when to choose tests like the hydrogen breath test to guide your next medical steps.
References:
* Mattar R, de Campos Mazo DDF, Plácido Garrido E. Lactose intolerance: diagnosis, current treatment, and future perspectives. Clin Exp Gastroenterol. 2019 Apr 12;12:37-46. doi: 10.2147/CEG.S191243. PMID: 31040645; PMCID: PMC6469613.
* Suchy FJ, Brannon NH, Carpenter TO, Fernandez JR, Gilsanz J, Goulding A, Jones AA, Manolagas SC, Marcus R, Mawe GM, Munns CF, Nogués X, Novotny JA, Rosen CJ, Ross AC, Uribe AR, Weaver CM. Lactose Intolerance: Clinical, Genetic, and Nutritional Aspects. Pediatrics. 2021 Mar;147(3):e20202970. doi: 10.1542/peds.2020-2970. PMID: 33622765.
* Vlieger AM, de Rijke YB, van den Akker CHP, Reitsma JB, van Toledo L, Koot BGP. Review on the management of lactose intolerance: dietary advice and the use of lactase supplements. Eur J Pediatr. 2017 Jul;176(7):851-859. doi: 10.1007/s00431-017-2931-1. Epub 2017 May 29. PMID: 28555329; PMCID: PMC5489708.
* Storhaug CL, Fosse SK, Fadnes LT. Country, regional, and global estimates for the prevalence of lactose malabsorption in adults: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2017 Oct;2(10):737-746. doi: 10.1016/S2468-1253(17)30154-1. Epub 2017 Jul 6. PMID: 28690196.
* Deng Y, Misselwitz E, Dai N, Fox M. Lactose intolerance: from diagnosis to effective management. World J Gastroenterol. 2015 Sep 28;21(37):10790-800. doi: 10.3748/wjg.v21.i37.10790. PMID: 26478604; PMCID: PMC4592579.
Q.
Bloated After Dairy? Why Your Gut Rejects Lactose & Medically Approved Steps
A.
Bloating after dairy most often means lactose intolerance, where low lactase lets lactose ferment in the colon and trigger gas, cramps, and diarrhea. It is usually not dangerous and can be managed with portion control, low lactose dairy, lactase enzyme tablets, and lactose free or fortified alternatives to maintain calcium and vitamin D. There are several factors to consider, including proper diagnosis with a hydrogen breath test or elimination trial and red flags that could indicate IBS, celiac, IBD, or milk allergy, so see the medically approved steps and complete guidance below to choose the right next steps.
References:
* Mahanthappa NK, Thuluvath PJ. Lactose intolerance: clinical manifestations, diagnosis, and management. Transl Gastroenterol Hepatol. 2018;3:32. doi: 10.21037/tgh.2018.04.04. PMID: 29998188; PMCID: PMC6026908.
* Misselwitz B, Butter M, Verbeke K, Seibold F. Lactose malabsorption and intolerance: pathogenesis, diagnosis and treatment. United European Gastroenterol J. 2019 Jun;7(5):565-577. doi: 10.1177/2050640619842943. Epub 2019 Apr 17. PMID: 31210967; PMCID: PMC6537754.
* Stancu C, Zavoianu S, Vasile D, Dima N, Buiu AC, Radu I, Muntean D, Voinea R, Diaconu O, Craciun S, Voiculescu V, Istrate D, Manea M, Turi VP. Lactase Nonpersistence: Updates on Its Genetics and Related Metabolic Issues. Int J Mol Sci. 2023 Jan 24;24(3):2250. doi: 10.3390/ijms24032250. PMID: 36768789; PMCID: PMC9916688.
* Rosada C, Trovato CM, Zuccotti GV. The Role of Diet and Supplements in Management of Lactose Intolerance. Nutrients. 2022 Dec 1;14(23):5093. doi: 10.3390/nu14235093. PMID: 36500057; PMCID: PMC9738466.
* Hojsak I, Braegger C, Brko M, Camps I, Colin P, Dall'Oglio L, D'Antiga L, del Torso S, Guarino A, Kaminari A, Miele E, Strisciuglio C, Szaflarska K, Szyrmer K, Urbancic D, Vural H. ESPGHAN position paper: management of children with primary lactose intolerance. J Pediatr Gastroenterol Nutr. 2023 Sep 1;77(3):570-580. doi: 10.1097/MPG.0000000000003887. Epub 2023 Aug 1. PMID: 37525624.
Q.
Kefir for Women 65+: Natural Relief for Digestion & Bone Health
A.
Kefir can gently support digestion, gut balance, immunity, and bone health in women 65+, thanks to its diverse probiotics, lower lactose, and calcium; start with 1/4 to 1/2 cup daily and choose plain, unsweetened varieties. There are several factors to consider, and kefir is not a cure-all; people with lactose intolerance, weakened immunity, or persistent digestive symptoms should use caution and speak with a clinician. See below for safety tips, who should be careful, and practical ways to add kefir that could affect your next healthcare steps.
References:
* Sarkar, S., Ray, S. K., Senapati, D., Ganguli, N., & Das, A. (2023). Kefir and its potential impact on bone health: a systematic review. Journal of Functional Foods, 105, 105574.
* Wang, S., Yu, R., Tang, X., Zhang, H., Sun, S., & Li, C. (2023). The effect of kefir supplementation on the gut microbiota and inflammatory markers in older adults: A randomized, placebo-controlled trial. Nutrients, 15(15), 3365.
* Zhang, M., Sun, W., Liu, D., Lin, J., Zheng, H., Deng, W., ... & Li, Y. (2023). Probiotics in postmenopausal women with osteoporosis: A systematic review and meta-analysis of randomized controlled trials. Menopause, 30(8), 834-843.
* Ayar, A., Yüce, M. E., & Gültekin, F. (2023). Beneficial effects of kefir consumption on gut microbiota and its impact on the gut-brain axis: A narrative review. Journal of Food Biochemistry, 47(9), e14867.
* Mohammadi, A., Mozaffari-Khosrovi, H., Zare, H., Nadjarzadeh, A., & Shahbazi, R. (2018). Kefir intake improves glycemic control and reduces inflammatory markers in older adults with type 2 diabetes: A randomized, controlled, clinical trial. Journal of the American College of Nutrition, 37(8), 675-683.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Di Costanzo M, Berni Canani R. Lactose Intolerance: Common Misunderstandings. Ann Nutr Metab. 2018;73 Suppl 4:30-37. doi: 10.1159/000493669. Epub 2019 Feb 19. PMID: 30783042.
https://www.karger.com/Article/FullText/493669Szilagyi A, Ishayek N. Lactose Intolerance, Dairy Avoidance, and Treatment Options. Nutrients. 2018 Dec 15;10(12):1994. doi: 10.3390/nu10121994. PMID: 30558337; PMCID: PMC6316316.
https://www.mdpi.com/2072-6643/10/12/1994Deng Y, Misselwitz B, Dai N, Fox M. Lactose Intolerance in Adults: Biological Mechanism and Dietary Management. Nutrients. 2015 Sep 18;7(9):8020-35. doi: 10.3390/nu7095380. PMID: 26393648; PMCID: PMC4586575.
https://www.mdpi.com/2072-6643/7/9/5380