Free

E-Newsletters

Subscribe to receive the latest updates on health topics. About our newsletters

  • Housecall
  • Alzheimer's caregiving
  • Living with cancer

Causes

By Mayo Clinic staff

CLICK TO ENLARGE

Illustration showing small intestine
Small intestine

Lactose intolerance is caused by low levels of the enzyme lactase in your small intestine that lead to signs and symptoms.

Normally, the cells that line your small intestine produce an enzyme called lactase. The lactase enzyme attaches to lactose molecules in the food you eat and breaks them into two simple sugars — glucose and galactose — which can be absorbed into your bloodstream.

Without enough of the lactase enzyme, most of the lactose in your food moves unprocessed into the colon, where the normal intestinal bacteria interact with it. This causes the hallmarks of lactose intolerance — gas, bloating and diarrhea.

There are three types of lactose intolerance.

Normal result of aging for some people (primary lactose intolerance)
Normally, your body produces large amounts of lactase at birth and during early childhood, when milk is the primary source of nutrition. Usually your lactase production decreases as your diet becomes more varied and less reliant on milk. This gradual decline may lead to symptoms of lactose intolerance.

Result of illness or injury (secondary lactose intolerance)
This form of lactose intolerance occurs when your small intestine decreases lactase production after an illness, surgery or injury to your small intestine. It can occur as a result of intestinal diseases, such as celiac disease, gastroenteritis and an inflammatory bowel disease like Crohn's disease. Treatment of the underlying disorder may restore lactase levels and improve signs and symptoms, though it can take time.

Condition you're born with (congenital lactose intolerance)
It's possible, but very rare, for babies to be born with lactose intolerance caused by a complete absence of lactase activity. This disorder is passed from generation to generation in a pattern of inheritance called autosomal recessive. This means that both the mother and the father must pass on the defective form of the gene for a child to be affected. Infants with congenital lactose intolerance are intolerant of the lactose in their mothers' breast milk and have diarrhea from birth. These babies require lactose-free infant formulas.

References
  1. Lactose intolerance. In: Ferri FF. Ferri's Clinical Advisor 2010. Philadelphia, Pa.: Mosby; 2010. http://www.mdconsult.com/das/book/body/178347893-5/0/2088/0.html. Accessed Jan. 14, 2010.
  2. Marchiondo K. Lactose intolerance: A nursing perspective. Medsurg Nursing. 2009;18:9.
  3. Lomer MCE, et al. Review article: Lactose intolerance in clinical practice - Myths and realities. Alimentary Pharmacology & Therapeutics. 2008;27:93.
  4. Lactose intolerance. National Institute for Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/lactoseintolerance/index.htm. Accessed Jan. 14, 2010.
  5. Lactose intolerance. American Gastroenterological Association. http://www.gastro.org/wmspage.cfm?parm1=854. Accessed Jan. 14, 2010.
DS00530 Feb. 16, 2010

© 1998-2012 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.

Print Share Reprints

Advertisement


Text Size: smaller largerlarger