Why could I drink milk just fine before, and now it doesn't agree with me? | Dr. Carlo

Question 1

Why could I drink milk just fine before, and now it doesn't agree with me?

Accepted Answer

Most often, your small intestine makes less and less lactase, the enzyme that digests lactose. That's why it can start when you're young or an adult, even if milk never bothered you as a child. It can also follow a gut infection or another bowel condition, and your doctor can tell those apart.

Question 2

Why do lactose-free, almond or soy milk bother me too?

Accepted Answer

If lactose-free or plant milk bothers you too, lactose isn't the whole story. Soy has other fermentable sugars, some brands add thickeners or sweeteners, and lactose-free milk still has milk protein. Irritable bowel syndrome causes similar symptoms. Write down what you drink and how much, and take it to your visit.

Question 3

Are plain yogurt and kefir easier to tolerate, or can they still cause bloating?

Accepted Answer

They usually sit better than milk. During fermentation the bacteria use up part of the lactose, and their own lactase keeps breaking it down in your gut. Some still remains, so very sensitive people can get bloated. If even kefir bothers you, something besides lactose may be involved.

Question 4

When should I take lactase, and is it safe to take every day?

Accepted Answer

Take it with the first sip or bite, so the enzyme goes in with the milk and can break down the lactose. Lactase pills only supply the enzyme you're missing and are considered safe and well tolerated. There's less data on daily long-term use, so that's worth talking over with your doctor.