Lactose Intolerance

Lactose intolerance is difficulty digesting lactose — the sugar in milk — because the body makes too little of the enzyme (lactase) that breaks it down. The undigested lactose reaches the large intestine, where bacteria ferment it, causing gas, bloating and diarrhoea.

It is more common than most Indians realise

Once we cross childhood, lactase activity naturally declines in many Indians — particularly in southern and eastern India. Lactose intolerance is a normal adult state in most of the world's population. It is not an allergy; it is not dangerous; it is simply a digestion issue.

Symptoms after milk products

• Bloating, gas, belching.
• Abdominal cramps.
• Loose motions.
• Nausea.
• Symptoms usually appear 30 minutes to 2 hours after the food.

Diagnosis

A Health Expert can suggest a 2-week trial of avoiding lactose and then reintroducing it. Formal tests — hydrogen breath test, lactose tolerance test — are available if the picture is unclear or other conditions are suspected. It's worth ruling out coeliac disease, IBS, and other causes of similar symptoms.

Managing it — most Indians can keep some dairy

• Small amounts with meals — many people tolerate small amounts of milk with food better than a large glass on its own.
• Fermented dairy is often well-tolerated — curd (dahi), paneer, buttermilk (chhaas), most cheeses. Bacteria in fermented foods break down much of the lactose.
• Lactose-free milk — widely available.
• Lactase enzyme tablets taken with milk help many people.
• Plant alternatives — soy, almond, oat, coconut milk — for those who prefer to skip dairy. Choose fortified versions for calcium and vitamin D.
• Keep calcium and vitamin D up — green leafy vegetables, ragi, sesame, small fish with bones, fortified foods, sunlight, and supplements if needed.

Cow's-milk allergy is different — an immune reaction, sometimes serious; commoner in infants. If there is rash, swelling, vomiting, or breathing trouble after milk, see a Health Expert — this is not lactose intolerance.