What you need to know about IBS and dairy products
This post is for general information purposes only, is not meant to diagnose or treat, and is in no way a replacement for consulting a medical professional.
A little while ago, I polled the members of my online community, IBSuccess, to see if there were any types of food they were avoiding to help reduce their IBS symptoms.
A large number of them replied that they were avoiding dairy products, and dairy avoidance is something I run across often in my practice!
It seems to be a common idea in the IBS community at large that dairy is a trigger food.
So should you be avoiding dairy products in order to improve your IBS?
The short answer is… no!
But keep reading for what you need to know about dairy and what to watch out for.
Dairy vs. Lactose
Often people are avoiding all dairy in general as a method of avoiding lactose. But these two words do not represent the same thing – and this difference is pretty important.
Dairy refers to all product originating from milk, like butter, cream, yoghurt, cheese, ice cream, and milk itself.
(FYI… eggs are not a dairy product – this is a common misconception, probably due to the fact that they are often grouped together in the grocery store! When you stop to think about it, it makes sense that it’s not dairy, right?)
Lactose is a type of sugar, or carbohydrate, that is present in some dairy products. Each lactose molecule is made up of two sugar molecules, one glucose molecule and one galactose molecule. In order to digest and absorb lactose our digestive system needs to split the lactose molecule into glucose and galactose. We need the enzyme, lactase to do this.
Lactose intolerance is when someone doesn’t produce sufficient lactase enzymes to break down the lactose being consumed. When that happens, symptoms like bloating, gas, cramps, and diarrhea can result. (Hint, this is why lactose is considered a FODMAP!)
Many people see a decrease in their natural lactase production from childhood until early adulthood. However, some people retain their higher level of lactase production throughout their lives. You can also experience a temporary reduction in lactase as a result of certain illnesses where the gut lining is damaged.
Not all dairy products contain lactose, so even if you are lactose intolerant, there are some products you are likely to be able to eat without issue.
Some people have dairy allergies – this is a reaction to a protein in dairy products (remember, lactose is a carbohydrate). For these people, an immune response can be activated which for some could result in a life-threatening reaction, like anaphylactic shock. These people need to avoid all dairy products. While lactose intolerance can produce some pretty uncomfortable results, exposure to it in sensitive people isn’t going to be life threatening.
(There is a metabolic condition where the person needs to avoid all traces of galactose – one of the sugars in the lactose molecule where the results can be life-threatening, but this is very different from lactose intolerance.)
From here on out, we are going to focus only on lactose intolerance.
What dairy can I consume if I am lactose intolerant?
Traditional Dairy Products:
Milk and yoghurt are the two big ones when it comes to lactose content. That being said, even with lactose intolerance you may find that yoghurt is digested OK as the fermentation process can improve lactose digestion. This would also count for other fermented milk products like kefir or buttermilk.
What’s also important to note is that most people with lactose intolerance can tolerate small amounts of lactose, so avoiding it completely isn’t necessary. Spreading out the servings across the day can also help.
It’s estimated that lactose intolerant people can tolerate around 12-15 grams of lactose per day, which is roughly 250ml of cow’s milk. This amount could be more if the intake is spread over the day. Milk may also be digested better when it’s been included in the meal, like adding milk to mashed potatoes.
However, as mentioned before, not all dairy contains lactose, so some sources you can consume without an issue even if you’re lactose intolerant!
Butter contains no lactose, and many cheeses are also virtually lactose free. Hard cheeses like cheddar or feta and also some softer cheeses like brie or camembert are essentially lactose-free.
If you look at the nutrition label and see that there are zero grams of carbohydrates, then the cheese is lactose-free! (Lactose is a carbohydrate/sugar, remember?) And as long as the amount of carbohydrates is less than 1g per 100g of cheese, then that cheese should be OK for most people with lactose intolerance.
You can also discuss with your pharmacist about taking a lactase enzyme product. This might help your digestive system breakdown the lactose when you consume lactose-containing foods.
There are also many dairy products that you can purchase that are “lactose-free”. These products usually have had the lactase enzyme added to them during production, so the splitting of the lactose molecule has been done for you!
Cow’s milk that is lactose free is virtually the same as regular cow’s milk, except that the lactase has been added. The taste may be a little bit sweeter, but the nutritional value will be the same.
What to watch out for if your avoiding / limiting dairy products
Dairy products in general are one of the main sources of calcium in our diet. Guidelines can vary, but in general the recommended daily intake of calcium for an adult is around 950mg. For reference, 100ml of cow’s milk contains about 120mg of calcium.
Vitamin B2 is another nutrient that needs attention if you’re limiting your dairy intake.
If you go for dairy-free alternative products to things like milk and yoghurt made from products such as soy, oat, almond, etc. you want to be taking care to choose ones that are fortified with, at a minimum, calcium (at least 120mg per 100g) and vitamin B2.
The bottom line on IBS and dairy products
IBS and lactose intolerance are not one and the same, and just because you have irritable bowel syndrome does not automatically mean you need to be avoiding lactose.
Many dairy products are naturally low in lactose and can be still enjoyed by people who are lactose intolerant.
Small amount of lactose, especially when spread over the day, may be digested well by lactose-sensitive people without any symptoms.
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