Sharing moments Menopause Young adults Bye bye Hotel Mum How you feel at home Semester abroad Language course abroad or work as an au pair? Be prepared for military training Grassrooted Pack smarter, travel better Make an impression Contraception Vegan diet Bye bye Hotel Mum – hello shared flat Big trip, small budget Finanzielle Vorsorge Planning a family Tracking fertility The right time? How men can help Fertility and diet Medical check-up What you need to know about ovulation What to do if you don’t conceive straight away Three electronic fertility and cycle trackers in comparison Planning a family and partnership Pregnancy Examinations during pregnancy Diet and nutrition Is my pregnancy progressing normally? Tips for daily life Important points for travel and holidays Is my pregnancy progressing normally? What items do I need for my baby? Where and how do I want to give birth? What do I need to pack for the hospital? How should I prepare my home for my child? Is my pregnancy progressing normally? How can I best prepare for my baby? How can I best prepare for the birth? Nutrition Parent-child relationship Preparing for breastfeeding | Sanitas Magazine Insurance Stretch marks Sleep Rupture of membranes Baby blues High-risk pregnancy Braxton Hicks & false labour Formalitites Morning sickness Family rooms Signs of a premature birth Our baby Bathing baby – what you need to know How babies hear Infant first-aid kit Baby care Is my baby developing normally? Month-to-month overview of baby development Is my baby developing normally? Baby’s development: Months 3 and 4 Baby care Breastfeeding When does a baby start eating? Weight Baby growth spurts Toys Sun protection for baby skin Teething Milk teeth: what to do in case of accident Baby’s development: Months 5 and 6 Pelvic floor exercises after birth Babyschlaf Celebrating and enjoyment Christmas and New Year’s Eve with a twist A philosophical take on pleasure Pleasure can also be found in the soup kitchen in Zurich Tips for a peaceful and stress-free Christmas Living better with cardiac insufficiency Alejandro Iglesias Hana Disch Patrizio Orlando Vaccinations and travel first-aid kit Hay fever In pursuit of happiness Seven tips for a happier daily life Kids in lockdown Online addiction Women's hearts Decisions Decision-making tips Report from the hospital Donating a kidney Life decisions Emigrating to South America Geocaching Sexuality Erectile dysfunction Young people and sexuality Queer pastor Drag queen Paprika Sexually transmitted infections What does LGBTQIA+ stand for? Gender medicine HPV Families of transgender people Medically assisted suicide Types of dementia Family Blessing or curse? Knowing about hereditary diseases Families of dementia patients Be active Active during pregnancy Sport and exercise during pregnancy Antenatal exercise classes Standing properly Healthy eating Green smoothies Vitamin D Good eggs, bad eggs Diet plan Healthy fats Feed your muscles How much sugar should we eat a day? How much fat should we eat a day? Lactose intolerance Healthy diet, strong immune system Low Carb E-numbers and other additives in food Personalised diet Vegan meat substitutes Brain food: what should we eat? Healthy heart Interview with Christophe Wyss Heart-friendly sports How the mind affects the heart Taking blood pressure correctly High blood pressure: what you need to know Healthy teeth Home remedies: relief for sore gums A dentist explains Brushing up on brushing Changing habits Interview Stortpsychologie 10-step guide to changing habits Try, try, try again Fitnessmotivation Running coaching Running ABC Race in Sarnen Factors affecting condition Weekly planner Running shoes Strengthening exercises Running nutrition Complementary sport Warm-up Stretching Functional clothing Fitness tracker Shopping – sportswear Running tips for women Relaxation technique Recovery New lease of life thanks to Sanitas running coaching Sport after childbirth Postnatal exercise Taking the strain off your shoulders Kangatraining Workout while walking Expert tips Stress and relaxation Moving air Fight stress with yoga What is stress Learn how to relax Dealing with stress What is burnout? “The first step was to create boundaries” Juggling family and a career Reduce stress Stressor factors The most beautiful Swiss saunas Sweating in the sauna Breathing exercises for relaxation The right rest & recovery: debunking myths Mindfulness Sleep Constant availability: chronic stress Trend sports Fitness boxing Slackline Bouldering Fascia training Stand Up Paddling Keeping fit efficiently Swing with a smile! Vertical workout Hiking Altitude sickness Seven stroller-friendly hikes Needed: a hiking-friendly pushchair There goes the other sole! Tips on hiking with a baby Mountain lakes Winter walks Planning a family: Fertility and exercise Stair climbing Pumptrack Kids’ back Back exercises Sitting properly at work Forest fun Playing for life Promoting health and fitness Motivation Sledging Curling glossary What do you get if you cross a kite with snow? Snowshoeing Preventing falls Inline skating Swimming Swimming Wings for Life Stretching Bike tips Stretching exercises for cyclists koerper-und-kaelte Healthy teeth thanks to dental hygiene and preventive care Putting wishes into practice Tips for healthy teeth Hometraining Investigating teeth-related myths 10 tips to ease anxiety Hand care How our body regenerates The best abdominal exercises in five minutes Keeping fit on holiday Swim training aids Wie viel Sport ist gesund Gathering mushrooms – the right way | Sanitas Magazine Check-ups Five-minute stretching routine Gehirntraining Rückenschmerzen Licht Yogastile Ayurveda-Morgenroutine Tips for doing sport outside in winter Cross-country skiing for beginners Home remedies against dandruff Home remedies Home remedies for bladder infections Home remedies for a sore throat Home remedies for migraines Home remedies against excessive sweating Home remedies for a sun allergy Healthy feet, healthy back core exercises for mountain bikers Symptoms Check Sport after Corona HIIT: quick and efficient exercises Sore muscles: debunking myths Debunking swimming myths strength training for young people Exercise videos Whole-body workout Fascia training Lack of exercise Sun protection Strong mind How to be mentally strong Mental strength Psychosomatics Resilience Tips against feeling down Sleep hygiene and mental well-being Depression Panic attacks Prescription drug addiction ADHD: Symptoms in children and adults Mental illness: help for friends and family Living with autism Pressure to perform Alcoholism Mental health benefits of exercise Ways to brighten your mood Blood: myths and facts Hormones Complementary medicine: the most common treatments Complementary medicine Training in line with your menstrual cycle Living together today Digital life Online addiction Digital temptation Children and digital media Smartphone neck Digital responsibility and solidarity Our brains love habit Change my habits? You’re joking! Planning a family: Difficulties trying to have a baby Planning a family: Myth vs fact Solidarity study Newcomers Living together tomorrow Digital nomads Giesserei multi-generation house The blind film director Help instead of rent Working on the move Medical practices of the future Our skin – layer by layer Generational discussion: wishes for life Hausarzt und Corona Safe return to work Corona crisis: singing together Corona crisis: Working in intensive care Corona crisis: working in a nursing home Rest and recovery: learning from children Corona crisis: voluntary work for the needy Second opinion Relationships and children Three questions that keep us awake at night Outing The nature of lying Vorsorge Finding sound health-related information online Impfstoffe entwickeln Tipps für Jugendliche in der Corona-Krise Becoming parents Diagnose: Kind im Haus Long Covid Take it easy in your free time YouTuber Aditotoro on the coronavirus pandemic Minimalism for a happy life Thanks to corona: more time for family Back to life after a paragliding accident Decluttering: the answer to chaos Living and loving with autism Synaesthesia Talking to doctors Non-verbal communication Is there really a serial killer gene? Developments for the future App check Aqualert SRC blood donor Codecheck Forest Freedom Freeletics Three sleep apps reviewed PeakFinder Findery Six fitness apps reviewed Internet use High-tech trousers Prostheses Hospital of the future New skin for burns victims Online-Therapien How drugs are developed Generics A vision of the future: How we will live in 30 years Onward Overcoming erectile dysfunction Family medicine practices of the future Personalised medicine A voice for Clara Outpatient procedures
Dossier: Healthy eating

Lactose intolerance: when your stomach rebels

Increasing numbers of people are being diagnosed as lactose intolerant – even later in life. A dietician explains why and what you should do if you think you’re lactose intolerant.

Text: Katharina Rilling; photo: i-stock

Every day for the last six months or so, a patient has suffered from pain and rumbling in her lower stomach that only ends once it’s completely empty. She rarely meets up with friends anymore, preferring to stay at home and take it easy. Eventually, things got so bad that she had to go to the doctor.

“The patient was scared. The doctor asked her to keep a diary of her symptoms. This way they discovered that she was lactose intolerant.The flatulence usually occurred one to three hours after eating, and the symptoms – cramps, diarrhoea, vomiting – worsened over the course of the day.”  Brigitte Baru is a dietician who works at the aha! Swiss Allergy Centre. She looks after patients in the university hospital, answers queries on the centre’s advice hotline and gives training courses on nutrition, for example for restaurateurs.  

Who is most affected by lactose intolerance?

Lactose intolerance may be the most common food intolerance in Switzerland, but it came as a surprise to the 40-year-old patient. “It's no wonder! Anyone who has drunk milk with no problems all their life doesn’t immediately think they may be lactose intolerant,” says Baru. “But it can occur suddenly at any age. It often happens after a bowel infection when you may have had to take antibiotics.”

Genetics also play a role. In fact, people around the world tolerate dairy products to varying degrees. In Asia, nine out of ten people show an adverse reaction to lactose. You’ll rarely find milk on the menu there. In Europe by contrast, 80 to 90% of people have no problems with lactose. “Intolerance is increasing as a result of globalisation and mixing of the global population,” explains Baru.  

But why do some people, – we are higher mammals after all – tolerate lactose of all things so badly? “As adults, we’re no longer actually supposed to drink milk. However, our bodies have adjusted to the intensive livestock farming and high milk consumption throughout history.”

What is lactose intolerance?

The sugar in the milk of mammals is called lactose and consists of galactose and glucose. Normally the lactose in the small intestine is split into its two components by the enzyme lactase so that they can be absorbed into the blood through the intestine. However, some people suffer from a lactase deficiency, either due to heredity or caused by an illness. Instead of entering the bloodstream, lactose reaches the large intestine undigested and is fermented there by bacteria. This fermentation process causes pain and problems with digestion.  

Getting diagnosed  

More and more people believe they’re lactose intolerant. Is it really true or just their imagination? “It’s true that we’ve been getting a lot of inquiries about this lately,” confirms Baru. “People today are better informed when it comes to their diet. This means they’re able to pinpoint their symptoms more easily than a few years ago. In the past, people suffered a lot longer without saying anything.”  

However, she’s sceptical about self-diagnosis, because there are many other diseases in the intestinal tract that the general public aren’t familiar with. “You should always consult an expert.” Otherwise you may suffer unnecessarily for years. “Nowadays we use nutrition diaries and diet to find out how much lactose a person can tolerate. For example, some people don’t notice the effects until after their third milky coffee,” says Baru.   

Not all tests are the same  

After talking to the doctor, being tested is a sure-fire way of finding out whether you’re lactose intolerant or not. However, there are major differences between tests. Although blood and genetic tests show whether you’re predisposed to lactose intolerance, they don’t provide any information on whether you actually are lactose-intolerant or not. The H2 breathing test is the only way to really know where you stand. In this test, the patient takes lactose in a controlled manner and records their symptoms in a log book. After three hours, the amount of hydrogen in their blood is measured. However, as this test is time-consuming and costly, it’s no longer offered in many places.   

Eating healthily despite lactose intolerance  

“You don’t have to include cow’s milk and dairy products in your diet,” says Baru, “There are many plant-based alternatives available today that are healthy, particularly if they’re enriched with calcium and vitamins.” In fact, Baru says with a laugh, if you’re going to develop an intolerance, lactose intolerance is the best one to have. There are even many dairy products available today without lactose. “These contain an enzyme that breaks down the lactose.”   

Today, many people who are lactose intolerant don’t have to go without. But you’ve got to be careful if you’re eating out or relying on ready meals, because you’ll find lactose hidden in virtually every meal. Whether it’s in the sauce, spice mix or mashed potato, small quantities are often added to change the taste, colour or volume of the food on offer.   

Consequences of lactose intolerance  

What happens if lactose intolerance goes untreated? Do you shorten your life expectancy by subjecting your intestine to permanent stress? Are you at risk of bowel cancer? “There’s no need to worry”, says Baru. “The intestinal mucosa is not affected. It doesn’t get inflamed or change in any way. Once the lactose has gone, everything returns to normal.”