Answers
What is lactose intolerance?
Short answer
Lactose intolerance means the gut cannot fully digest lactose, the natural sugar in milk. It causes gas, bloating, cramps or loose motions within a few hours of having milk. It is very common in adults in India and is not dangerous. Most people can still enjoy curd, paneer and small amounts of milk.
Symptoms
Lactose intolerance is not the same as a milk allergy, which is uncommon in adults and can cause rashes, swelling or breathing problems.
- Bloating, gas and rumbling after milk, tea with lots of milk, kheer or milkshakes
- Cramps or loose motions within 30 minutes to a few hours
How to find out
The simplest test is to avoid milk for two weeks and see whether symptoms improve, then reintroduce it. A hydrogen breath test can confirm it. If symptoms continue without milk, other causes such as IBS or celiac disease should be checked.
What you can still eat
- Curd, lassi and chaas, as the bacteria break down much of the lactose
- Paneer and hard cheese, which contain very little lactose
- Small amounts of milk with meals, often well tolerated
- Lactose-free milk, available in many stores
Getting enough calcium
If you cut down milk, get calcium from curd, paneer, ragi, sesame (til), green leafy vegetables, and lactose-free milk. See a doctor if there is weight loss, blood in the stool, or symptoms that begin for the first time after age 45.
Hidden milk sugar to watch for
Eat more
- Curd, chaas and lassi made from curd
- Paneer and hard cheese
- Lactose-free milk, or small amounts of milk with a meal
Cut down
- Large glasses of milk, milkshakes and kheer on an empty stomach
- Khoya and milk-based sweets, ice cream and milk powder
- Some protein powders, chocolates and bakery items with milk solids
Good to know
- Most people can manage up to about one cup (250 ml) of milk at a time, especially with food.
- Tea with a little milk is usually fine.
Common questions
Can lactose intolerance start in adulthood?
Yes. The enzyme that digests lactose naturally falls after childhood, so many adults in India develop symptoms gradually.
Is it permanent?
Usually, but tolerance varies. After a stomach infection, it can be temporary and improve over a few weeks.
Does it damage the gut?
No. It causes discomfort but no damage. If there is weight loss, blood in the stool or anaemia, another cause should be looked for.