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Do Gut Microbes Contribute to Symptoms of Lactose Intolerance?

People with lactose intolerance may suffer significant digestive distress when they consume dairy products. Gut microbes contribute.
Do Gut Microbes Contribute to Symptoms of Lactose Intoleranc...
A variety of dairy products including cheese, milk and yogurt.

Lactose intolerance is a common complaint. Sufferers describe bloating, cramping, abdominal pain, flatulence and loose stools or outright diarrhea upon consuming dairy products.

Presumably, the sugar in milk, called lactose, is the principal culprit. Babies everywhere produce an enzyme called lactase that breaks this sugar down. But as people grow into adulthood, many lose the ability to produce lactase. Genetics plays a role in this process (Gut, Nov. 2019). So, too, does diet. Many people find that their symptoms increase when they drink milk or eat dairy-based foods after abstaining.

Researchers now propose that gut microbes are critical to the development of lactose intolerance symptoms (Gut, Jan. 2022).  They noted that Bifidobacterium bacteria, in particular, are more abundant in the intestines of those with lactose intolerance.

How Are Gut Microbes Linked to Lactose Intolerance?

The scientists analyzed symptoms, genetics, the gut microbiome and diet among 959 Dutch adults. None of these individuals avoided dairy products completely, although some limited their consumption. Their analysis shows that people reporting lactose intolerance symptoms of stomach pain, discomfort and bloating had more Bifidobacterium gut microbes.

They also found that discomfort triggered by consuming dairy products could be explained by the abundance of Bifidobacterium. In conclusion, these scientists believe that the bacteria ferment lactose. In their view, the buildup of these lactose break-down products causes people with lactose intolerance trouble.

What Gut Microbes Do You Host?

One way to find out if your gut microbes are contributing to your discomfort is to test yourself. Verisana.com, a sponsor of our podcasts, offers a home test of gut flora & biome analysis.

Coping with Lactose Intolerance:

Many people with lactose intolerance manage their symptoms by avoiding most dairy products in their diet. Should they wish to indulge in a small amount, they may take a lactase tablet.

Probiotics may also provide some relief from symptoms. One study found that a specific strain of Lactobacillus alleviated cramping, diarrhea and vomiting (Nutrition Journal, May 20, 2016).  Chilean scientists reported that adding the probiotic Bifidobacterium bifidum to ice cream reduced the symptoms of lactose intolerant volunteers about as well as lactase tablets (Foods, Oct. 15, 2021).  Meanwhile, investigators in Iran described the benefits of probiotic yogurt fortified with Bifidobacterium and Lactobacillus acidophilus (Food Science & Nutrition, Jan. 20, 2021).

If you decide to try probiotics to help ease your lactose intolerance, we have confidence in the products supplied by the sponsor of our podcasts, KayaBiotics.com.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
  • Misselwitz B et al, "Update on lactose malabsorption and intolerance: pathogenesis, diagnosis and clinical management." Gut, Nov. 2019. http://dx.doi.org/10.1136/gutjnl-2019-318404
  • Brandao Gois MF et al, "Role of the gut microbiome in mediating lactose intolerance symptoms." Gut, Jan. 2022. http://dx.doi.org/10.1136/gutjnl-2020-323911
  • Pakdaman MN et al, "The effects of the DDS-1 strain of lactobacillus on symptomatic relief for lactose intolerance - a randomized, double-blind, placebo-controlled, crossover clinical trial." Nutrition Journal, May 20, 2016. DOI: 10.1186/s12937-016-0172-y
  • Aguilera G et al, "Improvement in lactose tolerance in hypolactasic subjects consuming ice creams with high or low concentrations of Bifidobacterium bifidum 900791." Foods, Oct. 15, 2021. DOI: 10.3390/foods10102468
  • Masoumi SJ et al, "The effect of yogurt fortified with Lactobacillus acidophilus and Bifidobacterium sp. probiotic in patients with lactose intolerance." Food Science & Nutrition, Jan. 20, 2021. DOI: 10.1002/fsn3.2145
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