Cheese, pizza and ice cream are fan favorites — but for those with lactose intolerance, they come with a side of bloating, cramps and discomfort.
So why does dairy cause trouble for some people but not others?
We asked an expert for the signs, causes and treatments for lactose intolerance.
1. It’s not the same as a dairy allergy.
Lactose intolerance and dairy allergies are often confused, but they’re very different.
“Lactose intolerance happens when your body doesn’t produce enough lactase, the enzyme needed to break down lactose,” says Anant Agarwalla, MD, at Hartford HealthCare’s Digestive Health Institute. “A dairy allergy, on the other hand, is an immune reaction to proteins in milk and can be much more severe.”
While lactose intolerance can cause bloating, gas and stomach pain, a dairy allergy can trigger symptoms like hives, swelling and even life-threatening anaphylaxis.
2. Symptoms look different for everyone.
Some people can handle small amounts of dairy, while others react strongly to even a splash of milk in their coffee. Common symptoms include:
- Bloating
- Gas
- Diarrhea
- Stomach cramps
“How much lactose you can tolerate depends on your body’s lactase levels,” says Dr. Agarwalla. “Some people might be fine with hard cheeses or yogurt, while others may need to avoid dairy entirely.”
Because of that, it’s common to have lactose intolerance without realizing it.
“I often see patients who never considered dairy as the source of their digestive issues. But once they’ve cut it out for a few weeks, they often notice huge improvements,” Dr. Agarwalla notes.
> Related: 3 Reasons Why You’re Bloated After Eating
3. Diagnosis can be simple.
Unlike many other conditions, you don’t always need a test to diagnose lactose intolerance.
“A simple at-home test is to eliminate dairy for one or two weeks, see if your symptoms improve, and then reintroduce it and note any changes,” says Dr. Agarwalla.
But for a more definitive answer, doctors can perform a hydrogen breath test to measure how your body processes lactose.
4. It’s more common than you think.
Lactose intolerance isn’t rare — it’s actually the norm in many parts of the world. Studies estimate that about 65% of the global population has some degree of lactose intolerance.
“It’s more common in certain ethnic groups, but in the U.S., that number is a lot lower – closer to 15-25%,” notes Dr. Agarwalla.
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5. Some dairy products are easier to digest than others.
You might be able to handle some dairy products comfortably, while others leave you suffering.
“Hard cheeses like cheddar and Swiss, as well as yogurt with live cultures, tend to be better tolerated because they contain lower amounts of lactose,” says Dr. Agarwalla. “Lactose-free milk is another great alternative — it’s real milk, just with the lactose broken down for easier digestion.”
And keep an eye out – dairy is hidden in many foods besides milk and cheese.
“Dairy can sneak into processed foods, sauces, dressings, even some medications,” says Dr. Agarwalla. “Look out for ingredients like whey, milk solids and casein, which all contain lactose.”
6. There are tons of dairy-free options out there.
These days, avoiding dairy doesn’t mean giving up your favorite foods. From almond and oat milk to dairy-free ice cream and cheese, the options are better than ever.
“Look for unsweetened plant-based alternatives to keep added sugar in check,” says Dr. Agarwalla. “And if you’re trying a dairy-free cheese, go for one made with nuts or soy for a more natural texture and flavor.”
7. And plenty of other ways to add calcium to your diet.
Worried about missing out on the calcium that dairy provides?
Luckily, many other foods are rich in calcium.
“Leafy greens, almonds, tofu and fortified plant milks are all excellent sources of calcium,” says Dr. Agarwalla. “You don’t have to rely on dairy.”
8. Lactase supplements can help.
Can’t seem to leave cheese behind? Lactase enzyme supplements might be an option.
“Taking these tablets, like Lactaid, before eating dairy can help make lactose easier to digest,” says Dr. Agarwalla. “It’s not a perfect fix, but for some people, it allows them to enjoy small amounts of dairy without discomfort.”
9. If you suspect lactose intolerance, it’s time to see a doctor.
If dairy consistently leaves you feeling bloated and uncomfortable, it’s worth getting checked out.
“Keeping a food diary and noting when symptoms occur can help identify triggers,” says Dr. Agarwalla. “A doctor can also recommend tests to confirm lactose intolerance and rule out other digestive conditions.”
And remember – lactose intolerance doesn’t mean giving up dairy or putting up with discomfort.
