Ever feel bloated, gassy, or just generally icky after you eat? You’re not alone. Stomach discomfort is incredibly common, and identifying the cause behind it can be maddening. Two of the most common perpetrators of these symptoms are lactose intolerance and small intestinal bacterial overgrowth (SIBO). While they may sound similar, they’re quite different—and knowing which one you have can make all the difference in how you address it.
Understanding Lactose Intolerance
Lactose intolerance is when your body cannot digest lactose, which is the natural milk sugar found in milk and milk foods like cheese, ice cream, and yogurt. Normally, an enzyme called lactase digests lactose. But if you produce too little lactase, lactose moves through your digestive system undigested. When it enters your intestine, bacteria in your intestine feed on it and cause gas, bloating, stomach cramps, diarrhea, constipation, or nausea.
Some others also get fatigue, headaches, or trouble concentrating, but these are less common. Lactose intolerance is not the same as a dairy allergy, however. A milk allergy can cause very dangerous, life-threatening reactions. Lactose intolerance, while uncomfortable, is not as dangerous.
What If It’s More Than Just Dairy?
If your symptoms are not confined to dairy, you may have SIBO. Your gut health happens to include trillions of bacteria, the majority of which reside in the large intestine. In SIBO, though, these bacteria overgrow or migrate into the small intestine, where they do not belong.
When that occurs, they begin fermenting the sugars and carbs you consume too early in the digestive process, producing the same symptoms: bloating, gas, pain, and changes in bowel habits. SIBO may even disrupt your nutrient absorption, causing you to lose weight, feel fatigued, or become vitamin-deficient.
Diagnosing the Problem: The Hydrogen Breath Test
So, how can you tell which one you have? One thing many doctors use to diagnose both lactose intolerance and SIBO is the hydrogen breath test—a quick, painless test that can diagnose both conditions.
Here’s how it goes: You’ll ingest a solution of sugar, then take breaths in at regular intervals into a special device. When bacteria in your digestive tract ferment undigested sugars, they release hydrogen (and occasionally methane), which passes into your bloodstream and escapes when you exhale. How much and when the gas appears in your breath assists physicians in deciding if lactose isn’t being broken down correctly, or if bacteria in your small intestine are fermenting food too soon (a symptom of SIBO).
Prepping for the Test
Preparation is the key to receiving accurate results. For the days leading up to your test, you might have to exclude some foods, drugs, and even activities that may influence the results. You will also be fasting for approximately 12 hours before the test. The test itself typically takes a few hours, and as uncomfortable as it may be, it’s not painful and can only induce mild symptoms of what you’re already dealing with.
How to Manage Lactose Intolerance
If you’re diagnosed with lactose intolerance, the first step is usually adjusting your diet. That might mean limiting or avoiding dairy, or trying lactase supplements before meals to help digest lactose. Some people can tolerate small amounts of dairy, especially yogurt or hard cheeses, while others may need to cut it out completely. If your child is showing signs of lactose intolerance, it’s best to talk to their doctor before making major changes.
Treating SIBO
SIBO treatment usually starts with antibiotics to decrease bacterial overgrowth, followed by diet modification and sometimes nutritional supplementation, particularly if the condition has caused weight loss or vitamin deficiency. In a few cases, individuals with SIBO also might require avoiding lactose for a while, as injury to the small intestine may impact how your body processes milk sugar.
When to See a Doctor
If you’re experiencing persistent digestive problems, don’t suffer through them quietly. Your symptoms may be a result of something as simple as lactose intolerance or something more intricate, such as SIBO. Consulting with a healthcare professional can assist you in monitoring symptoms, obtaining the proper tests, and developing a treatment solution that suits your way of life.
Digestive health is often complex, but the proper diagnosis and treatment can do a lot to make you feel your best.
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