Crohn's disease and lactose intolerance share many of the same symptoms. You may believe you have one condition when you really have the other. Also, Crohn's is a relatively rare disease. A doctor could initially mistake its symptoms for the much more common lactose intolerance. Studies have shown that those with Crohn's disease have a higher incidence of lactose intolerance than the general population. Still, a diagnosis of Crohn's doesn’t necessarily mean you will develop lactose intolerance.
Crohn's disease is a serious and chronic inflammatory bowel disease (IBD). It can cause serious illness or disability if left untreated. Lactose intolerance, on the other hand, is a condition that you can easily treat. It may best be described as a nuisance. It’s very important to know the difference between the two so that you can receive the proper treatment.
Lactose intolerance, also known as lactase deficiency, is due to a person’s inability to produce enough (or any) of the lactase enzyme in the small intestine. This enzyme digests lactose, a sugar found in dairy products.
Lactase breaks down the lactose into a pair of simpler sugars: glucose and galactose. Both sugars absorb quickly through the small intestine and release into the bloodstream. If someone doesn’t have enough lactase, however, the small intestine can only digest a portion of the lactose. 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 how much depends on the amount of lactase in their bodies.
Contrary to popular belief, lactose intolerance isn’t a type of food allergy.
As many people age, they begin to lose some of their lactase 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 people who are not Jewish. Lactose intolerance is also more common in those with Crohn's disease than those without, but doesn’t cause the illness.
It’s also important to note that lactose intolerance is not harmful — even for those suffering from Crohn's disease — although it may add to a person's discomfort.
For some people, the lactase enzyme may be inducible. This means that if a person regularly exceeds the amount of lactose they can normally tolerate, their body may respond by increasing the amount of lactase it produces.
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:
- abdominal pain
- excessive flatulence (gas)
These symptoms occur during the fermentation process in the colon. As the bacteria act on the lactose, it turns into an acid, which then produces gas.
In addition to the other symptoms, the acid may cause anal burning as well.
Like lactose intolerance, cramping and persistent diarrhea usually accompany Crohn's disease. However, a person with Crohn's may also find blood or mucus in the stool. Other symptoms of Crohn's that aren’t 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 they consume dairy products.
The easiest way to diagnose lactose intolerance is to avoid dairy products such as milk, cheese, yogurt, and ice cream and see if the symptoms go away. If, after one week, you consume a glass of milk and the cramps and diarrhea return, it’s highly likely you are lactose intolerant.
Another more objective way to test for lactose intolerance is to have a doctor order a lactose breath test. When lactose metabolizes in the colon, the bacteria will release hydrogen into the bloodstream that can then be measured in the breath.
Currently, there are only two ways to treat lactose intolerance. You can avoid dairy products completely, or you can consume 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 their diets with vitamin D and calcium, by taking supplemental tablets.