"Lactose intolerance is harmless"
Luise Heine has been an editor at since 2012. The qualified biologist studied in Regensburg and Brisbane (Australia) and gained experience as a journalist in television, in the Ratgeber-Verlag and in a print magazine. In addition to her work at , she also writes for children, for example for the Stuttgarter Kinderzeitung, and has her own breakfast blog, “Kuchen zum Frühstück”.
More posts by Luise Heine All content is checked by medical journalists.Anyone who pays to enjoy ice cream, mozzarella or other dairy products with flatulence or diarrhea is likely to be lactose intolerant. Gastroenterologist Dr. Ralph Czekalla.
Dr. Ralph Czekalla
Dr. Czekalla, people seem to be more tolerant of milk today than they did a few years ago.
I think that's a subjective feeling. The problem has actually been perceived more strongly for a number of years. The expansion of the product range for lactose-free foods has certainly also contributed to this. Corresponding intolerance tests are now used more frequently in our practice - but this does not mean that more people are lactose intolerant than before.
What actually happens with a lactose intolerance?
Those affected do not tolerate the lactose contained in some foods so well because they cannot break it down sufficiently. This happens when the lactase is not working enough. This is an enzyme that is produced in the intestinal mucosa and is responsible for breaking down milk sugar, called lactase. In the course of life she becomes more and more "lazy". Then fermentation processes occur in the intestine with flatulence and abdominal cramps.
So older people are more likely to be lactose intolerant?
In general, the lactase activity in babies is still very high, but it decreases over time - more in one, less in the other. Therefore, the intolerance can occur in both younger and older patients.
Can you prevent the enzyme activity from decreasing, for example by drinking a lot of milk?
Sounds like a good idea, but unfortunately it doesn't work.
At what amounts of milk sugar does someone with lactose intolerance develop problems?
It differs from patient to patient. One has problems after a coffee with milk, another only after three scoops of ice cream. However, most of them do not have any problems with lower amounts of lactose; symptoms only appear above a certain threshold value.
So I can be lactose intolerant without even realizing it?
Yes, if you do not exceed your individual threshold - and this limit can really be very different.
Can I test myself whether I have lactose intolerance?
Only the doctor can determine this objectively, for example with a breath provocation test. The hydrogen content of the air you breathe is measured after consuming a fixed amount of lactose. If it can only be broken down poorly, it is fermented in the intestine. This creates hydrogen, which reaches the lungs via the blood.
To get a first impression, you can also do a so-called stress test yourself. That means you drink a liter of milk and then see if you get any symptoms like gas, cramps or diarrhea.
How quickly do such symptoms appear?
Usually within the first two hours. But there are also patients who only notice something much later - but that is rather rare.
Can a lactose intolerance also go away?
This is possible in individual cases - but only if it occurs as a result of another disease - for example, if the intestinal mucosa becomes inflamed or malignant. This restricts lactase production and the patient has problems consuming dairy products.
Do you have an example of such a disease?
A classic example is gluten intolerance, in which the intestinal mucosa also changes inflammatory. If those affected then eat gluten-free for a while, the intestines calm down and the patients can tolerate lactose again. With such so-called secondary lactose intolerances, the process is reversible, but lactose intolerance is normally a one-way street.
So there is no cure?
No. But lactose intolerance is actually a harmless thing. Such a diagnosis needn't worry you. Many increase in it - but you can live with a lactose intolerance very well if you follow a few rules.
And what would they be?
Either you eat a comparatively low lactose diet, or - if you do not want to do without cream, milk and the like - use lactose-free dairy products. Here the lactose was already broken down during processing. There are also many dairy products in which bacteria have broken down most of the lactose - these include yoghurt and long-matured cheese. These are well tolerated by most people with lactose intolerance. There is also the option of taking lactase in tablet form with meals - for example when you are on vacation or going out to eat. Then you will not feel anything of your intolerance.
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