Can Lactose Intolerance Be Treated or Managed Effectively? - Nutrition

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Is lactose intolerance curable?


Hello, doctor.
I think I might have what is known as "lactose intolerance" because I easily get diarrhea after drinking milk, especially when paired with food! Although it's not 100%, it happens more than 90% of the time.
I also experience issues when drinking milk tea (especially if it's made with fresh milk) and sometimes even yogurt (including Yakult).
I've had this since I was young, and it has never improved.
Although "lactose intolerance" is not a disease, it can be quite debilitating.
Is there any treatment for "lactose intolerance," or will I never be able to consume milk again? (I can drink it on an empty stomach, like for breakfast, but only in very small amounts; otherwise, I will get diarrhea.) Thank you for your response, doctor.

KFG, 10~19 year old female. Ask Date: 2009/01/25

Dr. Xie Peiru reply Nutrition


Lactose intolerance, also known as lactose malabsorption or lactose digestion deficiency, refers to the condition in which the body does not produce enough lactase, the enzyme responsible for breaking down lactose.
The main symptoms include diarrhea and bloating after consuming large amounts of lactose.
Lactose intolerance can be classified as either primary or secondary.
Primary lactose intolerance may be present from birth, while secondary lactose intolerance may develop after the age of 3 to 7.
It is important to determine which type you may have.

If it is primary lactose intolerance, it is advisable to limit dairy products due to the genetic nature of the condition, which cannot be changed.
For secondary lactose intolerance, dietary choices can include starting with small amounts of yogurt or kefir, as they contain beneficial bacteria that can help break down some lactose and alleviate diarrhea symptoms.
Gradually increase the intake by 10-20 c.c.
each day to enhance intestinal tolerance and modify the gut microbiome.
It is crucial not to stop midway, as this may lead to a return of symptoms upon reintroducing dairy.
Typically, symptoms can improve within one to two weeks, but if there is a break in consumption, lactose intolerance symptoms may return.
If symptoms persist, it is recommended to consult a gastroenterologist.
Wishing you a happy Year of the Ox!

Reply Date: 2009/01/25

More Info


Lactose intolerance is a common condition that affects many individuals, particularly those of certain ethnic backgrounds. It occurs when the body lacks sufficient amounts of lactase, the enzyme responsible for breaking down lactose, the sugar found in milk and dairy products. As a result, undigested lactose passes into the colon, where it is fermented by bacteria, leading to symptoms such as bloating, gas, diarrhea, and abdominal pain.

To address your question about whether lactose intolerance can be treated or managed effectively, the answer is multifaceted. While there is currently no cure for lactose intolerance, there are several strategies that can help manage the condition and allow individuals to enjoy dairy products without discomfort.

1. Dietary Modifications: The most straightforward approach is to limit or avoid foods that contain lactose. Many people with lactose intolerance can tolerate small amounts of lactose, especially when consumed with other foods. You mentioned that you can drink milk on an empty stomach in small quantities, which suggests that you may have a mild form of lactose intolerance. It may be beneficial to keep a food diary to track which foods trigger your symptoms and to what extent.

2. Lactose-Free Products: Many grocery stores now offer lactose-free milk and dairy products. These products have been treated with lactase, allowing individuals with lactose intolerance to enjoy dairy without experiencing symptoms. You might find that lactose-free milk, yogurt, and cheese are good alternatives that can be included in your diet.

3. Lactase Supplements: Over-the-counter lactase enzyme supplements are available and can be taken before consuming dairy products. These supplements provide the enzyme that your body lacks, helping to digest lactose and potentially preventing symptoms. It’s important to follow the instructions on the packaging and consult with a healthcare provider to determine the appropriate dosage for your needs.

4. Gradual Introduction: Some individuals find that they can gradually reintroduce small amounts of dairy into their diet, allowing their digestive system to adapt over time. This approach may not work for everyone, but it could be worth trying under the guidance of a healthcare professional.

5. Probiotics: Some studies suggest that probiotics may help improve lactose digestion and reduce symptoms of lactose intolerance. Probiotics are beneficial bacteria that can be found in fermented foods like yogurt and kefir, as well as in supplement form. Incorporating these into your diet may help improve gut health and tolerance to lactose.

6. Consultation with a Healthcare Provider: It’s essential to work with a healthcare provider or a registered dietitian who can help you navigate your dietary options and ensure that you are still receiving adequate nutrition. They can also help rule out other conditions that may mimic lactose intolerance, such as irritable bowel syndrome (IBS) or other gastrointestinal disorders.

In summary, while lactose intolerance cannot be cured, it can be effectively managed through dietary changes, the use of lactose-free products, lactase supplements, and potentially probiotics. Many individuals with lactose intolerance can still enjoy dairy in moderation or through lactose-free alternatives. It’s crucial to listen to your body and find a balance that works for you, allowing you to maintain a varied and enjoyable diet without discomfort. If symptoms persist or worsen, seeking further evaluation from a healthcare professional is advisable.

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