Lactose Intolerance

Because Crohn's disease and lactose intolerance share many of the same symptoms, a person may believe she is suffering from one condition when it is, in fact, the other.

Also, since Crohn's is a relatively rare disease, a doctor may initially mistake its symptoms for the much more common lactose intolerance. Although studies have shown that those with Crohn's disease have a higher incidence of lactose intolerance than the general population, a diagnosis of Crohn's is not a predictor that a person will develop lactose intolerance or vice versa.

Crohn's disease is a serious and chronic inflammatory bowel disease (IBD) that may cause serious illness or disability if left untreated.

Lactose intolerance, on the other hand, is a harmless condition that is easily treated and may best be described as a nuisance. Therefore, it is very important to know the difference between the two so that the proper treatment may be prescribed.

What is Lactose Intolerance?

Lactose intolerance, also known as "lactase deficiency," is caused when a person doesn't produce enough of a certain enzyme in the small intestine to digest lactose, a sugar found in dairy products.

The enzyme—lactase—breaks down the lactose into a pair of simpler sugars; glucose and galactose, both of which are quickly absorbed through the small intestine and released into the bloodstream.

If someone does not have enough lactase, however, only a portion of the lactose will be digested. The undigested lactose continues down through the small intestine and into the colon where bacteria work on the sugars in a process known as fermentation. Most people with lactose intolerance can digest at least some lactose, but the amount will differ depending on the amount of lactase in their bodies.

Contrary to popular belief, lactose intolerance is not an allergy.

Symptoms of Lactose Intolerance

As the undigested lactose travels through the small intestine, it draws in water through osmosis.

This excess water is responsible for the cramps and diarrhea sometimes associated with the condition.

Other symptoms of lactose intolerance include:

  • bloating
  • nausea
  • abdominal pain
  • excessive flatulence

These symptoms occur during the fermentation process in the colon. As the bacteria acts on the lactose, it turns into an acid, which then produces gas.

In addition to the other symptoms, the acid may also cause anal burning as well.

Key Differences In Symptoms of Lactose Intolerance vs. Crohn's Disease

Like lactose intolerance, Crohn's disease is usually accompanied by cramping and persistent diarrhea.

However, a person with Crohn's may also find blood or mucus in the stool. Other symptoms of Crohn's that are not typically found with lactose intolerance are a loss of appetite, unintentional weight loss, fever, fatigue and anemia.

Crohn's disease may go into remission for weeks or months at a time with few or no symptoms. A person with lactose intolerance will experience symptoms every time he consumes dairy products.

Who is at Risk for Lactose Intolerance?

As many people age they begin to lose some of their lactose enzymes, making them less able to digest foods containing lactose.

The condition is more common in those of Asian and African descent than Caucasians, as well as in Jewish people over non-Jews.

Lactose intolerance is also more common in those with Crohn's disease than those without (46.9 percent versus 16.6 percent according to one study), but does not cause the illness.

It is also important to note that lactose intolerance is not harmful—even for those suffering with Crohn's Disease—although it may add to a person's discomfort.

For some people, the lactase enzyme may be inducible; which means that if a person regularly exceeds the amount of lactose he can normally tolerate his body may respond by increasing the amount of lactase it produces.

Testing for Lactose Intolerance

The easiest way to diagnose whether or not a person is lactose intolerant is for her to avoid dairy products such as milk, cheese, yogurt and ice cream and see if the symptoms go away. 

If, after one week, she consumes a glass of milk and the cramps and diarrhea return, it is likely she is lactose intolerant.

Another more objective way to test for lactose intolerance is to have a doctor order a lactose breath test. When lactose is metabolized in the colon, the bacteria will release hydrogen into the bloodstream that can then be measured in the breath.

Treatments for Lactose Intolerance

Currently, there are only two ways to treat lactose intolerance; either by avoiding dairy products completely or by consuming additional lactase enzymes in the form of an over-the-counter supplement such as Lactaid. Additionally, people who give up dairy may need to supplement vitamin D and calcium in their diets.