Ask a doctor: Am I lactose intolerant?

You’re feeling nauseated and bloated after eating a big bowl of ice cream — does that mean you’re lactose intolerant, or did you just scoop a bit too much?

First, you should understand what an intolerance is: the body’s inability to adequately digest or tolerate certain foods. With dairy, it refers to your ability to divide and digest the two sugar molecules that make up lactose.

Food intolerances are much different than allergies, which can be life-threatening. An intolerance can cause symptoms that range from mild and annoying to so severe they interfere with daily life or can be confused for something else.

Experts stress the importance of listening to your body to understand where you fall on the intolerance scale so you can best care for yourself.

The quick answer

If you’re experiencing mild or temporary gas, bloating, abdominal cramping or changes in bowel movements after consuming dairy, you may have a slight intolerance. Or it could be caused by other factors, such as eating a large quantity at once, not getting enough water throughout the day, or combining dairy with other commonly hard-to-digest foods like mushrooms, onions, garlic, beans, bananas, apples, peaches or pears, among others.

If your body can recover quickly or you don’t experience the symptoms every time you consume dairy, it’s safe to assume it was a momentary experience.

Take a deeper look

If you’re met with moderate to severe symptoms every time you have dairy, you may have an intolerance. This requires taking a closer look at what you’re eating — especially if those symptoms interfere with your quality of life.

Symptoms can hit anywhere from immediately after eating to two to three days later. It’s also important to know that if you have dairy multiple days in a row, those meals can build on top of each other and cause symptoms days later.

Food intolerances can also develop at any point in life, so just because you’ve been able to consume dairy until recently doesn’t rule out an intolerance now.

The best way to know if lactose intolerance is the source of your problem is to track your food, quantity and symptoms. If doing so shows that your symptoms start after meals with lactose, try cutting them out for at least three days. If your symptoms resolve, you likely have an intolerance.

If not, dig deeper. Could stress, anxiety or depression be the cause of your nausea? Track your mood as well to see if there’s a correlation. Or try eliminating other foods that align with your symptoms to see if you have an intolerance to those.

Gastroenterologists also recommend looking closely at foods considered high FODMAP, which can cause similar symptoms to lactose intolerance. FODMAP stands for fermentable oligosaccharides disaccharides monosaccharides and polyols, which, simply put, means different formations of different sugar molecules like lactose.

Still in doubt? Schedule an appointment with your primary care provider.

When to seek care

Treating an intolerance is simple — avoid the food that causes the symptoms.

But that isn’t always easy, and lactose can be one of the most challenging items to cut out. At the very least, try limiting how much or how often you consume lactose, and avoid having it daily so your symptoms can’t compound.

If you know you’ll be consuming lactose, try an over-the-counter product such as Lactaid, which adds enzymes required for proper digestion to the digestive tract. Keep in mind that digestive aids may not always help, and there’s little guidance on how much is needed for effectiveness.

If you’re avoiding lactose to the best of your ability and using digestive aids, but still finding little relief for your symptoms, schedule an appointment with your primary care provider.

If you experience sudden or severe symptoms, such as intense cramping or persistent vomiting or diarrhea, seek emergency care.

Medical review provided by Grant Bursell, MCHS, PA-C, MultiCare gastroenterology. Note: This information does not qualify as individualized medical advice. Please schedule an appointment with your care team to ensure the most appropriate care.