Lactose intolerance or IBS?

Lactose intolerance can sometimes be mistaken for Irritable Bowel Syndrome. If your body cannot break down the lactose in dairy products and absorb it into the blood it can cause bloating, flatulence, gas and diarrhea.

Lactose is a naturally occurring sugar found in cows milk, also goat and sheep. It is also present in dairy foods such as yoghurt, cream and cheese, some cereals, biscuits (especially rich and buttery ones) and chocolate.

Lactose is useful as it helps the body to absorb calcium and magnesium, but certain people lack an enzyme known as lactase, which is produced by the small intestine. If the lactose is not dealt with there, it will pass into the colon, and that is when the unpleasant symptoms of intolerance begin.

Lactose occurs in certain ethnic groups who have not traditionally had milk as part of their diet. Apparently before humans began to keep cattle, sheep and goats for meat, hide and milk, all humans were intolerant to lactose, save that present in mother's milk. Over thousands of years most humans have adapted to lactose, but not all.

Lactose intolerance can be found it is estimated in 50–80% of people of south Indian, black or Ashkenazi Jewish and Hispanic ethnicity, and nearly all (100%) people of American Indian, or Asian, ethnicity. If you belong to one of the ethnic groups mentioned, and have stomach problems when you drink milk or eat a dairy product, it is possible that you have a lactose intolerance rather than IBS. Unfortunately, it is possible to have both, but as with IBS, there are certain steps you can take to make the symptoms less painful.

It is impossible to prevent intolerance, and symptoms can range from mild to acute depending on how much dairy is included in your diet. Also some people can digest lactose better than others, but there is no way of predicting who is more tolerant and who less. Some people with intolerance can, for instance, eat yoghurt or cheese, but cannot drink milk.

It is possible these days to buy a lactase substitute if your symptoms are especially severe, but you should seek advice on your diet if you strive to avoid lactose entirely, as this may mean you become deficient in certain important minerals, such as calcium, which can also be taken as a supplement. This is especially important for children, who traditionally get most of their calcium intake through milk and dairy products.If you or your child think you may have lactose intolerance, you should try cutting down on certain dairy products, and perhaps try a soya milk substitute. If you have a day free of milk or dairy, and you feel better, then it may be that you do have an intolerance. Then you could try some cheese the next day, or some yoghurt and see if this causes any symptoms. Milk is always the biggest trigger as it contains the most lactose. A doctor should be able to provide you with alternatives and supplements. Cows Milk can be substituted for almond milk, coconut milk, rice milk, soy milk.

Lactose intolerance is not to be confused with food allergies, where the body treats certain proteins in food as harmful. This can cause the same symptoms as intolerance, nausea, even vomiting, bloating, gas and stomach cramps, and also others like nettle rash (hives), scaly patches of skin, hayfever like symptoms, (runny nose, itchy eyes.) or even flu-like ones, aching joints, headaches, shivers. (I am allergic to MSG; it makes me feel as if I am about to go down with flu'.)

Not much is known of general food allergies, although they definitely exist, as I know several people that are allergic to different kinds of food, from strawberries to spices in curries.

Because tiny quantities of a certain allergens may be present in many foods, it is often difficult to avoid trigger foods completely. Skin prick testing and blood tests can ascertain certain allergies, but not all, and trials are still ongoing as more people seem to becoming allergic to certain ingredients in foods these days.

We will look at other food allergies and intolerances such as nuts, shellfish, cereals and eggs in further articles.